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Gepubliceerd in: Journal of Rational-Emotive & Cognitive-Behavior Therapy 2/2023

Open Access 31-05-2022

At the Coalface: Practitioner Perspectives on Applying Rational Emotive Behaviour Therapy (REBT) in High Performance Sport

Auteurs: Martin J. Turner, Nanaki J. Chadha, Helen Davis, Muhammad S. Deen, Hugh Gilmore, Jennifer K. Jones, Scott Goldman, Mark Terjesen

Gepubliceerd in: Journal of Rational-Emotive & Cognitive-Behavior Therapy | Uitgave 2/2023

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Abstract

The reported usage of rational emotive behaviour therapy (REBT) in high performance sport is becoming more common in research literature. This research indicates that REBT is a useful and effective approach to performance psychology. However, applied professional practice reflections and insights remain sparse. The current paper brings together REBT practitioners who work predominantly in performance settings (i.e., sport) to answer three questions pertaining to their application of REBT. Practitioners were asked to respond to the following questions: (1) What do you consider to be among the main irrational beliefs that interfere with performance? (2) In your experience, which irrational beliefs impair one’s ability to recover from a significant injury or major setback? (3) Can you describe the role of cognitive restructuring/change/reappraisal/disputation in applied work as it relates to performance? In the present paper, the practitioners’ responses are collected and presented, following which common themes are drawn from the responses to form guidance for practitioners wishing to apply REBT in performance settings. It is hoped that the experiences of the included practitioners will be useful for those wishing to take an REBT approach to their performance psychology consultancy.
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High performance environments (HPEs), such as sport for example, are innately demanding. When operating within an HPE, one is subjected to failure, rejection, disapproval, unfair treatment, disrespect, arbitrary suffering, illness, injury, meeting self and others’ expectations, the challenge of repeating success, and ultimately, retirement (Fletcher & Arnold, 2017; Hughes & Leavey, 2012; Mellalieu et al., 2009; Nixdorf et al., 2013; Wylleman et al., 2015). This non-exhaustive list of demands can go unanswered, but if ignored, these demands present significant risk factors for mental and physical illness (Rice et al., 2016). If performers are not prepared for, and fortified against such vicissitudes, it is unlikely that they will fulfil their performance potential or achieve healthy living (Crocker et al., 2015). One approach that can offer preparation and armament for the inherent adversity that helps to define HPEs, and for which interest in performance literature is growing (Bernard, 1985; Turner 2019), is rational emotive behaviour therapy (REBT; Ellis 1957; 1994).
REBT is a humanistic approach to cognitive behavioural therapy (CBT) that encourages clients to understand that it is they who are in control of their responses to life’s adversities (Ellis, 1994). This control is exercised through recognising and undermining faulty and flawed ideas about themselves and the world, and developing and strengthening empirically valid and logically-consistent ideas about themselves and the world (e.g., DiGiuseppe et al., 2014; Dryden & Neenan, 2015). In REBT, it is one’s beliefs about adversity that underpins our emotions and behaviours. Whilst of course adverse events are conducive to unpleasant and unwanted emotion, our beliefs about those adverse events dictate the extent to which these emotions are functional for the pursuit, and attainment, of human potential (e.g., David et al., 2010). This is captured within REBT by the GABCDE framework (Ellis, 1994) whereby if individual goals (G) are thwarted by adverse events (A), healthy or unhealthy emotional and behavioral consequences (C) can arise, depending on one’s beliefs (B) about the self, others, and the world in relation to the event (A). The individual’s irrational beliefs (B) are disputed (D) before effective new rational beliefs (E) are formulated and strengthened. Rational beliefs (flexible, logical, and non-extreme) beget healthy emotions and adaptive behaviors, whilst irrational beliefs (rigid, illogical, and extreme) beget unhealthy emotions and maladaptive behaviors (Szentagotai & Jones, 2010). In athlete samples, irrational beliefs have been shown to be associated with poorer mental health (e.g., Turner et al., 2019), performance under pressure (Mesagno et al., 2020), and increased burnout (Turner & Moore, 2016). In short, irrational beliefs undermine goal attainment efforts, whilst rational beliefs facilitate goal attainment efforts (Turner, 2019). As such, practitioners who choose to adopt REBT as an approach to their work tend to focus their work with clients on the articulation of irrational and rational beliefs, with a view to enabling them to weaken irrational beliefs, and strengthen rational beliefs via a process if disputation (e.g., Cunningham & Turner 2016; Turner & Davis, 2019).
Although the REBT research and professional practice literature concerning performance settings has grown remarkably in the last ten years (Jordana et al., 2020), there are still sparse accounts of practitioners using REBT in their work (See Turner & Bennett 2018, for some exceptions). As such, in the present paper we present the accounts of five performance psychology practitioners, who are trained in REBT and use it frequently in their practice. In line with the core REBT tenets of irrational beliefs and disputation, we orient these accounts around three questions about applying REBT for performance:
1.
What do you consider to be among the main irrational beliefs that interfere with performance?
 
2.
In your experience, which irrational beliefs impair one’s ability to recover from a significant injury or major setback?
 
3.
Can you describe the role of cognitive restructuring/change/reappraisal/disputation in applied work as it relates to performance?
 
The formulation of these three questions was informed by the key tenets of REBT that help to distinguish it from other approaches to performance psychology practice. Thus, the questions focus on irrational beliefs and disputation, which are two essential elements to REBT practice. The questions were also informed by some ongoing ambiguity in the literature concerning the use of REBT in performance settings. For example, it is not yet clear which irrational beliefs are most deleterious for performers. Also, other CBT approaches, such as Acceptance and Commitment Therapy (ACT), do not encourage disputation as part of the work, and so, we wanted to know about the perceived importance of this component for performance psychology practitioners in their work.
Each practitioner answered these questions using their own reflections and interpretations, and in this paper we collate their responses. We do this so that readers, particularly trainee performance psychologists, can find utility in the reflections of experienced practitioners. The responses to each of the questions above are covered in turn, enabling the reader to gain a consensus across the practitioners whose expertise we sought. Each practitioner starts their first answer with a short statement about their expertise and experience so that readers can better contextualised the content. A caveat to the style and tone of writing is necessary at this juncture – the practitioners have varying backgrounds and approach the questions idiosyncratically as befits their unique experiences and expertise. As such, some practitioners offer theoretical and scholarly insights alongside their answers, whilst others choose to draw more heavily on their real-world experience and reflective judgement. Indeed, the current paper is special in part because it offers a range of voices for us the readers to learn from. Following the practitioners’ responses to the questions, we bring together the common themes in order to present the main take-away points. We begin in earnest with the first question.

What do you consider to be among the main irrational beliefs that interfere with performance?

Nanaki J. Chadha, Sport and Exercise Psychologist

I am a British Psychological Society Chartered Sport and Exercise Psychologist. I completed my primary practicum in REBT in 2017 and apply REBT in sport settings to help athletes adopt a more rational, logical, and pragmatic approach to performance and well-being. My research focuses on REBT in sport, and I have just completed my PhD (February 2022). I have provided psychology support to athletes across a wide range of age groups and skill levels, ranging from grass roots to national and international levels, and in sports such as cricket, golf, soccer, hockey, athletics, gymnastics, shooting, swimming, rowing, rugby, water polo, and taekwondo.
Based on my applied experience, the main irrational beliefs that tend to interfere with athletes’ performances are demandingness and self-depreciation. More often than not, athletes’ display their rigid demands via expressing common statements such as “I must not make mistakes”, “I have to qualify” and “I need to play well”, where cue words such as “must”, “need to”, and “have to” represent demandingness (Ellis, 1994). Individuals holding such rigid beliefs and unrealistic expectations tend to display a need for achievement and perfectionism. However, on failing to achieve perfectionism or the inability to perform up to their expectations, the athletes I have worked with often attribute these failures to themselves and display role-depreciating beliefs (e.g., “since I performed poorly in the competition, I am not good enough a player”) and self-depreciating beliefs (“I am a complete failure”). To elaborate, athletes tend to believe that they are only good enough when winning in competitions and evaluate themselves based on their athletic performances, thus, grounding their self-worth solely on their performance outcomes. Therefore, the demand for perfection and constantly aligning self-worth with the final outcome can result in emotional consequences among athletes that can then interfere with their performances.
The aforementioned opinion is also in support of previous research, where Flett et al., (2003) found associations between perfectionism and self-worth beliefs. The findings of the research indicated that perfectionists acknowledged their self-worth to be based on how they are evaluated by themselves and by others, and such as, are vulnerable to psychological distress when experiencing negative events that do not confirm their self-worth. Also, perfectionism was originally identified by Albert Ellis as an irrational belief, defined as “the idea that one should be thoroughly competent, adequate, intelligent, and achieving in all possible respects” (Ellis, 1958, p. 41) and “the idea that there is invariable a right, precise, and perfect solution to human problems and that it is catastrophic if this perfect solution is not found” (Ellis, 1962, p. 86–87). The self-depreciation brought about by perfectionism is prominent in sports where self and others evaluation is part and parcel of the context within which athletes are performing (Turner, 2016a). Also, in REBT literature, self-depreciation beliefs have been seen to cause emotional disturbances among mixed martial arts (MMA) athletes (e.g., Cunningham & Turner 2016).

Helen Davis, Sport and Exercise Psychologist

I worked as a teacher and educator for over 25 years in the UK and USA and now work as an applied sport psychologist running my own independent consultancy. I am a Chartered Sport and Exercise Psychologist (British Psychological Society) and completed my primary practicum in REBT at the University of Birmingham in 2017. I have worked in a variety of home and international high-performance settings since 2016, including with Commonwealth, Olympic, Paralympic, and World champions. I have also worked with wheelchair tennis athletes at Wimbledon and the US Open, Swim England, and Cambridge University Women’s boat race crews, and am currently sport psychologist to the England Women’s Rugby team.
In my experience the main irrational beliefs experienced by athletes are the primary irrational belief of demandingness and next, depreciation. For example, “I must always play consistently in golf”, “I’ve paid a lot of money for golf lessons therefore I should perform well”, and “I have to be the fastest in the squad”. Importantly, these demands are underpinned by the desire, or the preference, to succeed, transferred into the rigid demand for success. Clients who report irrational beliefs of demandingness tend to display performance-undermining behaviours such as (a) lack of motivation when underperforming, ‘giving up’ or finding it harder to push oneself, (b) concentration disruption, whereby clients find it difficult to remain on task, and (c) avoidance – clients remove themselves from the situation to avoid continuing to make errors or to not be exposed to disapproval from others.
The second most common irrational belief expressed by clients in my experience is depreciation. This ‘put-down’ thinking occurs when individuals are excessively critical about themselves, others or the world when they fail to live up to their self-imposed demands. Therefore, commonly depreciation follows demandingness. For example: “I have to be the fastest in the squad, and if I am not the fastest swimmer in the squad, then I am a failure”. Clients also express that “If I perform badly, I don’t think I’ll ever be good enough to be called a good rower, and therefore I will be a failure”. Common behaviours for clients who show irrational beliefs of depreciation where it impacts their performance are (a) pulling out of races/avoiding even entering a race they want to do, (b) isolating oneself from training groups and deliberately training on their own, (c) avoiding conversations with fellow athletes as they do not want to be drawn into performance related talk because it leads to anxiety, and (d) not entering certain level of competitions due to a fear of not being ‘good enough or fast enough’ to enter - even if the competition is open to all.

Muhammad Saqib Deen, Sport & Performance Psychology Consultant

I have been an independent sport psychology consultant for 7 years, 6 of which have been working internationally with elite athletes on a full-time basis. I consulted at the Olympic Games in Tokyo 2021. I hold the primary and advanced certificate in REBT from the Albert Ellis Institute. I have keen interests in exploring motivational interviewing and counselling techniques in applied sport psychology work, and also how REBT can be adapted to incorporate culture and diversity. I am currently studying for a PhD investigating the relationship between rationality and resilience.
It is important to highlight that there are numerous perspectives which are linked to performance from a psychological perspective, both directly and indirectly. Consider a snapshot of performance from a single event, a longitudinal/temporal collection of events, or a panoramic widescreen of a training environment, or even a round-the-corner look to injury prehab/rehab and sleep, or a deeper take on mental health and well-being, life stressors, media engagements etc. All of these factors impact on the ever-changing context in which athletes toil and can influence both individual and team performance. When discussing irrational beliefs, I prefer to expand slightly beyond the traditional and elegant model of REBT, to a more modern and integrated model of RE-CBT, which considers both philosophical beliefs and cognitive distortions (thinking errors) and how they relate to emotion and behaviour. Below are what I consider to be the chief irrational beliefs that undermine client performance.
Demandingness beliefs:
1)
I must not be judged negatively or critiqued openly as that will impact how others see me;
 
2)
I need to constantly prove my worth to myself and to others through results, otherwise I am worthless, either now eventually in the future;
 
3)
I have to have success in my career, as it would be a waste of all the years spent training and I will be a loser;
 
4)
I should get my way all of the time, because if I don’t I won’t be successful or as comfortable as possible;
 
5)
I must never make mistakes, because top performers don’t make mistakes;
 
6)
I need to always feel/be safe and secure within my team;
 
7)
I need to agree with all decisions made that impact on me;
 
8)
I have to be seen as important in the eyes of others.
 
Awfulizing beliefs:
1)
Receiving negative feedback/comments/reviews is awful and truly horrible;
 
2)
It’s awful to not be treated fairly;
 
3)
It would be awful to perform poorly.
 
Frustration intolerance beliefs:
1)
I cannot handle uncomfortable emotions, activities, or setbacks;
 
2)
It would be unbearable to lose face (be embarrassed in front of others);
 
3)
I cannot tolerate seeing others surpass me or doing better than me.
 
Depreciation beliefs:
1)
I cannot accept myself (I am a waste) if I don’t capitalise on my chances;
 
2)
Others who overtake me or outperform me are not that special (other downing);
 
3)
Life isn’t fair to me because I’ve had to face so many adversities.
 
How do such beliefs inhibit performance? The above beliefs are stress-producing/prolonging and resilience inhibiting beliefs, which ultimately produce distraction, and limit the growth of athletes as humans and performers. Irrational beliefs and unhealthy negative emotions will occur in everyone’s life, and may even occur frequently. But by ruminating and remaining stuck in such phases, athletes (like all humans!) will spend crucial time and energy being consumed by dysfunctional thoughts, feelings, and behaviours, which ultimately hinders their progression in their careers by way of blocking performance improvements and adaptive resilience. The practitioner has identified the above beliefs as a general guide to where the most common psychological barriers may occur, and these beliefs also apply to specific performance/in-play situations.

Hugh Gilmore, Performance Psychologist: British Weightlifting, British Athletics & English Institute of Sport

For the last 10 years I have been providing sport psychology support across national and international level athletes, including medallists across two Olympic/Paralympic games. I have also sat on the board of directors for a sport, and have been a coach educator in two very different sports (Team/Individual). I have worked with the English Institute of Sport, Sports Institute of Northern Ireland, Sport Wales, United Kingdom Coaching, British Weightlifting British Athletics, British Paralympic Association, Help for Heroes, Weightlifting Ireland, Northern Ireland Weightlifting, and Ulster Gaelic Athletic Association. I completed my advanced practicum in REBT at the Albert Ellis Institute in New York in July 2019, and am also trained in motivational interviewing. I am accredited as a sport psychologist with the Irish Institute of Sport, and my accreditation as a sport psychologist with the British Association of Sport and Exercise Sciences is pending.
In my experience the demandingness beliefs of “things must go as I want”, or “people must value me (above others)” are the two most common demands that are the root cause of issues with performers with whom I work. Within the professional/funded environment, there are few if any time points where an athlete is not appraising their shortcomings or having others appraising them and discussing how their input can help. This is especially the case within sports that are measurable (e.g., centimetres, grams, seconds, etc.). Athletes can perceive their self-worth to be contingent upon a successful Olympic performance, or the demonstration of successful attributes that give confidence in their performance to themselves and others. They often believe that their self-worth is tied to their athletic identity, valuing themselves on the basis of their likelihood of good future performances is commonplace across Olympic and Paralympic sport. In my experience, sport carries more meaning to the Paralympic athlete, as they are often unseen as athletes and at times in their personal life face staring judgements from members of the public (including being filmed because of their physical differences).
In the months prior to qualifying for Tokyo, I was repeating to many athletes that attendance at the cinema doesn’t make a person a better version of themselves, and then asking how attendance at the Olympics would make them a better person. This approach proved successfully in disputing “qualification” anxiety. However, while this is an effective dispute, athletes can come unstuck with the empirical, logical and pragmatic disputations, if the athlete does not understand the difference between healthy and unhealthy negative emotions. Even with a perspective that reduces the importance of the biggest competition of their life, the athlete still knows that the performance matters.
Lastly, in my experience the overuse the socially desirable descriptor “positive” in psychology and general society has helped to create athletes with the perception that wellbeing is a “permahappy” state. This has confounded athletes’ perception of reality with expectations to have continual “positive energy” and therefore a poor understanding and tolerance of healthy negative emotions is often present in this cohort.

Jennifer Jones, Performance Psychologist

I have been practicing as a performance psychologist for 7 years. I am a Chartered Sport and Exercise Psychologist (British Psychological Society) working in applied practice. I work with individuals and teams in high-risk occupations, predominantly policing, and across a range of professional and elite level sport. I hold both the primary and advanced practicum certificates in REBT which I gained at the Albert Ellis Institute in New York in 2016. I am currently in the final stages of my PhD program which explores the application of REBT in policing. I have also published a number of articles as lead and contributing author on the theory and application of REBT.
In REBT we work with four categories of irrational belief: demandingness, frustration intolerance, awfulizing, and global evaluation (depreciation), and often all four are at play in performance consulting. REBT theory posits that demandingness beliefs are at the core of emotional disturbance (Digiuseppe et al., 2014) and through my experiences of working with clients, I recognise demandingness as the, often hidden, creator of psychological chaos. From a performance perspective we know that healthy minds tend to strive for personal growth (Ryan & Deci, 2017) and there are many advantages to optimism, challenge, mastery, and striving for one’s dreams, but when those dreams are elevated in the wrong direction to irrational “musts” as opposed to “rational” performance objectives there is often a change in the quality of the performance experience. This change in quality can lead to individuals experiencing events as catastrophic performance failures or go un-noticed in the outside world (this, I think depends on the strategies individuals employ to hide their distress and “manage” to maintain their performance). I am an advocate of enjoying life, so putting oneself “through” the “adversity” of performance (even though that performance might be excellent from an onlooker’s perspective) is not what I encourage my clients to strive for.
I believe that where you find a person who is highly motivated to maximise their performances you will often see irrational demandingness associated with perfectionism, that is, going beyond striving for excellence to fulfil both an internal calling and an external contract or expectation to dogmatically believing that there is some absolute need to do so. The secondary irrational beliefs that are almost always also present create further weight to the psychological disruption which can interrupt performance. Often this disruption is associated with performance anxiety, which leads to a focus of attention on failure, extreme high stakes, and the risk of shame associated with looking foolish in front of others and letting important others down (e.g., coaches, teammates, family members).
It seems that the demandingness that is present can underpin choking under pressure as critical performance moments draw closer (Mesagno et al., 2020). If performers can foster a sense of grounding in reality and trust in their preparation psychologically, there is the chance that they remain free to execute the skills required when those skills are most needed. All too often performance demandingness beliefs (“I must perform perfectly well or excellently”) are the psychological spark that leads to a cascade of disruptive thoughts (i.e., reinvestment or paralysis by analysis), feelings (i.e., anxiety), physiological responses (i.e., tightness of movement, shaking hands) and behaviours (i.e., poor skill execution). Demandingness is at the core of such disturbances and can be an unconscious belief (Ellis, 1994) and, I think, other inferences can be “red-herrings” in doing efficient work. In my work I look for the demandingness with my client through reflective conversation and hypothesis testing and while other irrational beliefs may be more easily identified, I work with the rule of thumb that if I can find the demandingness and dispute that first then I am most likely to be working most effectively.

In your experience, which irrational beliefs impair one’s ability to recover from a significant injury or major setback?

Nanaki J. Chadha, Sport and Exercise Psychologist

In my experience, the irrational belief of “self-depreciation” that arises from demandingness impairs and delays an individual’s ability to recover from major setbacks. In research, self-depreciation has been strongly associated with emotional disturbances and negative affect during adverse events (e.g., Szentagotai & Jones 2010), and is a major predictor of depression (David et al., 2002), a finding echoed in sport research (Mansell, 2021; Turner et al., 2019). In the sporting environment, athletes are faced with a range of adversities (such as injury, deselection, and retirement etc.), and can engage in self-depreciating and self-blaming thoughts that can impinge their self-worth and impair their recovery process (e.g., “I am worthless, as I cannot compete or play the sport anymore” and “I am a failure, as I was not selected in the team”). Athletes’ self-worth is also reliant on approval from others as they place great importance to how others perceive them. On performing poorly, athletes can believe that significant others would judge them in a negative manner and that will make them “no good”. It is believed that individuals who are not self-accepting tend to be easily threatened by criticism as it generates an evaluation of worthlessness (Ellis & Dryden, 1997).
In the sporting arena, athletes are surrounded by their family and friends, coaches, teammates, and spectators. However, the requirement for continual sense of approval from others and placing their self-worth on others’ ratings can hamper the athlete’s growth and impair their ability to recover from major setbacks if the desired responses are not attained from individuals around us. Indeed, previous research recognizes that the socio-cultural environment has a great impact on an individual and the social agents present in the environment such as parents, peers, and significant others play a critical role in the psychological development of the person (Bronfenbrenner & Morris, 1998). As such, it has been argued that all societal and cultural institutions promote irrational beliefs to greater or lesser extents (Ellis, 1987). Lastly, the inability of athletes to view themselves as fallible beings, who are capable of making mistakes just like any of us, (see Turner, 2016b) makes them more vulnerable to emotional distress that can further hinder the recovery process.

Helen Davis, Sport and Exercise Psychologist

Awfulizing and frustration intolerance are common irrational beliefs that I have witnessed that impairs clients’ ability to recover from a significant injury or major setback. Thinking the worst is common-place with these athletes, and awfulizing is often expressed with language such as, “I’m never going to get better and that will be terrible”, “It is awful that there’s no way I’ll get back into the team”, and “I won’t be able to do achieve my goals in the future, which would be the worst thing ever”.
With frustration intolerance clients often present with language such as “I can’t stand not being able to do my sport”, “My body has let me down and I’m impatient - I want to get better now, it’s unbearable!” These two types of irrational beliefs stem from rumination about the injury, magnification and helplessness, where athletes dwell on negative thoughts based on their current levels of pain or lack of progress with rehabilitation. Impatience is also a prevalent characteristic, and one that sits alongside their frustration intolerance.

Muhammad Saqib Deen, Sport & Performance Psychology Consultant

In my experience when assisting athletes in dealing with setbacks and injuries, without a shadow of doubt, non-acceptance of adversities/life/self/others presents the largest challenge for athletes when setbacks occur. Where the other rational beliefs (non-dogmatic preferences, anti-awfulizing & frustration tolerance) are concerned, they are much more readily instilled at the intellectual level (athletes gets the concept, and agree with it), to the emotional level (athletes really feel and take on the rational belief). Athletes will find it most challenging to replicate the same progress with acceptances beliefs at both the intellectual and emotional level. Non-acceptance of adversities will lead to prolonged psychological dysfunction and therefore impair the ability to recover from a significant injury. It is not entirely clear why this the case, however in practice I have learnt that acceptance beliefs are easier to instil by creating foundations for understanding adversities through dialogue, and this will naturally unfold as an athlete may say “I don’t understand how…why did this happen…it’s so unfair…how could it be?…why me…why now…my chance is ruined…I can’t accept this”. Focusing on acceptance beliefs may present the most challenge, but also may result in the most reward for the athlete.
Where injuries are concerned, athletes will face difficulties in keeping up with rehab/prehab programmes as motivation to partake in them will fluctuate or wane, isolation from the team due to differing programmes and schedules, they may miss several opportunities to perform and suffer financial losses, incur medical costs, or risk rankings points. Acceptance of the numerous initial and knock-on adversities and stressors is therefore central and highly important to allow an athlete not just to bounce back, but come back in a truly healthy manner, and perhaps even surpass their levels prior to injury.

Hugh Gilmore, Performance Psychologist: British Weightlifting, British Athletics & English Institute of Sport

Recovery from a setback implies a trajectory and a goal; therefore it becomes linked to a demand of “I must perform again”, or “it must go well”. The compounding issue is that injury may occur at a critical point in time, potentially leading to deselection and forced retirement from sport. Therefore, the athlete’s beliefs may become demands like “It must not end like this”. Upon further exploration, the athlete’s demands may also be linked to the perceived status of how a career ends, or the impact of retirement. The phrases “what am I doing with my life?” and “I’m too old to be doing this” and “I haven’t achieved what I should have” have all been expressed to me in these contexts.
Female athletes especially have competing desires, for example, motherhood and sporting performance. There is a negotiation to be had and such trade-offs have in my experience become more prominent after a significant injury or major setback. To this end, I would caution that it is often a collection of demands that are disturbing the athlete and manifesting in withdrawal and self-pity during a setback, or as is common, silent suffering and loss of intensity in application. To explain why concepts like intent of movement are important, if an athlete is attempting to become 10 kg stronger over a year, that training adaptation occurs from a culmination of recovery to stress over a year. 10 kg divided by 365 equates to less than 28 g a session of progress. The margin between 0 and 28 g is immeasurable on a daily basis, and the athlete must move the weights with an intent to provide the stimulus needed to create the adaptation. Where intent of movement is not present could result in stagnation or decline. (This year we had an athlete qualify because of a difference in 20 g, they then went on to win a medal in Tokyo as an underdog.) The ability to self-regulate one’s mental state in a setback is of vital importance. In that vein, the quote “The impediment to action advances action, what stands in the way becomes the way” (Holiday, 2020) has been chosen by that group of athletes to be turned into a mural in the training hall, as a call to arms as to how they choose to deal with the brutality of training in elite sport.

Jennifer Jones, Performance Psychologist

The first irrational belief that springs to mind when I reflect on my experience of working with clients who are faced with significant (and sometimes insignificant) injuries are awfulizing beliefs, closely followed by intolerance beliefs, and global evaluations of self, others, and of the adversities themselves. Demandingness again is a core (sometimes unconscious) element contributing to irrationality in these cases. I think that when performers strongly identify with their setbacks, then their ability to recover is hindered. When athletes experience injuries, their ability to trust their body’s ability to withstand the challenges of their sport can be diminished.
Recently I have worked with athletes at either end on a scale of injury belief. One, a professional footballer, suffered a broken leg but had no doubts about making a full recovery, while another, a 100 m sprint athlete, suffered a hamstring strain which they believe is “just typical” of their athletic identity. The sprinter sees themself as an athlete who is “always injured” which, I think, prevents the athlete from adopting an optimistic outlook towards complete recovery and diminishes their experience of sport and life. In reality, getting injured, or facing setbacks, is a both a disappointing and an inconvenient part of a performer’s life, but the choice in perspective impacts one’s general attitude towards recovery or adaptation. For example, the football player mentioned above was able to fully engage in recovery relationships (e.g., with a physiotherapist), and recognise the value of recovering effectively through rest, while the sprinter found motivating themselves to engage positively with the processes which promote effective recovery much more of a challenge. The different psychological outlooks illustrate how irrational identities associated with both awfulizing and global evaluations (i.e., I am a person who is always injured, I am a person that always suffers setbacks so I will never reach my goals), hinders one’s ability to recover.

Describe the role of cognitive restructuring/change/reappraisal/disputation in applied work as it relates to performance?

Nanaki J. Chadha, Chartered Sport Psychologist

In my applied practice, I took the opportunity to apply REBT within an ecologically valid setting, where the athletes’ beliefs were identified and disputed during their actual play. The athletes were placed in performance situations that they often avoided due to fear and anxiety. In these situations, the players’ were encouraged to face their unpleasant situations and identify, dispute their irrational beliefs and then replace them with more rational performance enhancing beliefs. This particular approach provided an opportunity to work with athletes in their actual sporting environment and implement disputation on their specific performance beliefs. The exposure intervention has been considered to be an important component of REBT (Ellis, 1994). Research (e.g., Turner et al., 2020) has implemented exposure techniques with athletes and highlighted its importance in helping them overcome the negative influence of anxiety on performance (Jones, 1995).

Helen Davis, Sport and Exercise Psychologist

I describe the role of the above mechanisms for change as the intervention itself. I make it clear that there is ‘work’ to be done before we get to the bit where change can occur (A-C thinking and B in the REBT model). This is to enable me to thoroughly explain the model and ensure understanding before moving on. It also sets expectations for the client as they know there is not just ‘a quick fix’ in the first session - it is a process and there is work in the process too. This enables me to work on client self-awareness and self-reflection, educate the client in thinking types, identify irrational beliefs and learn the impact these beliefs are having on performance.
In relation to performance, I often describe the work and process of REBT like a ‘good foundation’ – a solid building block for learning, as clients are learning about themselves, the type of thinker that they are and how it relates to oneself and sport. Once the irrational belief/s is/are identified, the disputation phase is the intervention- the practice of skills that can give lasting change and I emphasise this to the client. The role of disputing can take many forms – verbal practice of examples, role play, written practice – real and invented scenarios. I choose these depending on my knowledge of the client and which method would resonate with them the most. I find that giving the client a wide variety of examples of disputing questions useful and find that they tend to adopt and remember ones that have been particularly effective in real life scenarios, and they become familiar with using those. Typically, I go through the process of disputation during one-to-one sessions, but some clients find it difficult to apply once they are ‘in the field’.
A tennis player for example is not going to go through the GABCDE on the court in the middle of a point. This is where I think REBT forms more of a philosophy in regard to performance – as REBT is practiced and applied in day-to-day life and training – the philosophy starts to form and embed. The use of reappraisal or restructured phrases can be discussed, planned and reviewed, as part of pre-performance routines, for example, and this planning can be used in performance settings. I talk about head/heart a lot with clients. The head knows it is rational and makes sense, but the heart does not always ‘feel it’. For clients to recognise that changing feelings is harder than changing actions can be enlightening – practising rational self-talk and planning rational self-talk is easier to do with their heads – learning to accept that the heart will follow with more practice and application makes sense to clients.
Athletes are good at learning processes in sports. When they have direction from a practitioner the approach makes sense as there is a process for them to follow with REBT. In my experience client’s welcome direction, they welcome the structure and recognise the sense of the process to help with performance. The therapeutic approach of REBT reflects the process that athletes appear to be able to adapt and implement. Methods learned in the REBT process are applied to new challenges and therefore clients can achieve independence from the practitioner - something which is relevant for performance as the practitioner is not there to guide them, we want them to do it on their own!
In sum, the role of disputing in applied work is the actual intervention where change starts to occur. It is all about regular consistent practice for change to occur, and it can inject variety into sessions in the way disputing is delivered. Cognitive restructuring can be planned and reviewed ahead of performance, but disputation really helps to form a new rational philosophy. Athletes welcome the process of disputation in part because they often like direction, but they also strive for independence, which the practitioner can help to ensure.

Muhammad Saqib Deen, Sport & Performance Psychology Consultant

Cognitive-behavioural techniques are highly effective in helping athletes to adapt and pursue their goals even in the face of inevitable adversity, especially if they occur during competition time. Cognitive restructuring has cemented its place in sport psychology support as a classical technique. Whether it be reframing nerves to excitement, a setback to an opportunity, a loss as a lesson – cognitive restructuring has the power and capability to change how a person feels almost instantly if applied correctly and the timing is right.
More often known as a cognitive Tterapy technique, cognitive restructuring also has its roots in REBT (Ellis, 2008), and thus disputation by its very nature is indeed the process of reframing and adjusting beliefs, attitudes and opinions about situations; at the primary and secondary level. “I can’t handle it” vs. “I can handle it”, “it’s terrible” vs. “it’s annoying”, “I need it” vs. “I want it”. Adjusting perspectives in such a way will adjust emotions, behaviours, and even physiological state, all of which will allow the performer to (a) perform at a higher level, (b) perform at a more consistent level, or even (c) have a more positive relationship with performing. Disputation techniques inherently ‘seal the deal’ by using logic, pragmatism, and evidence to enhance the buy-in for rational beliefs. Restructuring without disputation may even be a fruitless endeavour. With these techniques, the performer will adopt and own the beliefs for their own.
Considering performance gains, practitioners are left with a choice to dispute or not depending on the timing of interventions. Factors to consider when making such a decision as a practitioner are interpersonal factors between practitioner and athlete, the context/place of intervention, the allotted time for intervention, the actual time of the intervention (in the day and in proximity to performing), the overtly and covertly agreed level or depth and aims of psychological support, and also the suitability of such techniques with said athlete. In my work with performers, it is highly imperative to have robust confidence as a practitioner in the techniques applied and that disputation, coupled with additional mental skills training if needed can make significant performance gains even when time is ticking.

Hugh Gilmore, Performance Psychologist: British Weightlifting, British Athletics & English Institute of Sport

Disputation and the process of REBT in the performance environment has taken place in the classic format of, teach the model, and dispute the demands. However, there is often a much less formal approach taken depending on the client and the relationship with the client. My training in motivational interviewing has influenced my style of disputation, in that I will often dispute using a “complex reflection” which is set up to show the athlete their hypocrisy and therefore create cognitive dissonance and change. However, the complex reflections are targeted using the REBT framework of seeking areas where they express demands about self, others, and or life.
For example, an injured and defunded Paralympic athlete spoke about letting down their team because of their poor performances. This was challenged by stating: “You want to protect them from the lows of sport, so that their highs aren’t as high.” I followed this up later with: “You think that these people are your slaves and that they do not have a choice to leave you”. These disputations were later shored up with challenging the locus of control over other people (i.e., can cannot ultimately control others). Indeed, a classic issue with sport is that athletes are caring towards others, to their own detriment. In the example above, a rapid perspective shift occurred which was able to be targeted because of an understanding of the three core demands people place on themselves. Whilst the framework was not explicitly taught, elegant perspective shift occurred to relieve the athlete from their over-caring about their team, allowing them to trial focusing more on themselves in future competition.
REBT has also manifested itself in the building of culture in one of the sports that I work in, with Stoic quotes on the wall summarising the cultural document that was created by the athletes. The culture document expresses concepts of responsibility to self and to the team. The emphasis of seeking control and accepting the reality and difficulty of the sport whilst choosing one’s actions. This echoes Albert Ellis: “The best years of your life are the ones in which you decide your problems are your own. You do not blame them on your mother, the ecology, or the president. You realize that you control your own destiny” (Nemko, 2016).

Jennifer Jones, Performance Psychologist

The starting point in the change process is usually a change in perception and cognitive disputation plays a pivotal role in creating the opportunities for a broader perspective. Disputation of irrational beliefs that underpin inferences and generalisations about performance are often the first time that clients experience an alternative view of their performance problems. When rational alternatives are explored, several behavioural opportunities emerge which serve to create the philosophical change that leads to robust functional and healthy perspectives of the challenges faced in sport and performance settings.
In this respect disputation provides a strong foundation for philosophical change, but taking time to explore and challenge clients to behave in line with more functional beliefs through behavioural methods helps clients to experience the benefit of adopting their rational alternative beliefs first-hand.
I think when emotions are activated along with cognition and when things ‘feel real’, then change can come about. This might not happen in the process of cognitive disputation. Using methods that evoke a sense of the lived experience through desensitisation, imagery, or role play, for example, can be useful ways to behavioural dispute irrational beliefs. Also, through the use of REBT resources (disputation guides such as the Smarter Thinking App; Turner & Wood 2021) clients can challenge themselves to dispute their irrationality in the moment or close, in time proximity, to the occurrence of activating events which also facilitates faith in the theory that we teach in sessions.

Discussion

First, practitioners reflected on the main irrational beliefs that interfere with performance, chief of which appeared to be depreciation underpinned by contingent self-worth. Research indicates that depreciation is related to greater psychological distress in athletes (e.g., Mansell 2021), is strongly associated with emotional disturbance and negative affect during adverse events (e.g., Szentagotai & Jones 2010), and is considered a major predictor of depression (David et al., 2002). Thus, some applied work in sport has specifically targeted depreciation for change (Cunningham & Turner, 2016). But it is at present difficult to state why depreciation beliefs are so pernicious. Of all the irrational beliefs, depreciation is framed as highly negative, fatalistic, and very final. In one study, researchers found that REBT was able to enhance athlete self-efficacy (Chrysidis et al., 2020), which makes sense because it is hard to imagine an athlete having high self-efficacy in conjunction with a depreciation belief that they are a “complete failure”. The reasons why depreciation beliefs are harmful to performance needs further study, and researchers and practitioners are challenged to conduct ecologically valid research within high performance environments such as sport.
Demandingness also emerged as a key irrational belief that interferes with performance and was presented by some of the experts as underpinning the secondary beliefs. The notion that demandingness relates to, and influence emotional outcomes through, secondary irrational beliefs is consistent with REBT theory, and is supported in research outside of sport (Oltean et al., 2017), and within sport (Turner et al., 2019). Demandingness is especially relevant to sport because there are a great many ‘wants’ that can become ‘musts’ in the performance environment, and for the practitioners there was a sense that often athletes demand the things that they want. Some of these ‘musts’ are broad and global such as career success and goal attainment, whereas other ‘musts’ are more local and narrow such as tournament qualification, favourable treatment, and advantageous evaluation by others. Demandingness is a challenging irrational belief to address in performance settings, because efforts are often made to legitimise ‘musts’ under the potentially noble intension of striving to be the best. However, as cautioned in previous literature (Turner, 2019) there is a difference between conditional and non-conditional demandingness that practitioners need to be mindful of. When a demand is underpinned by a preference (“I want, therefore I must”) then we are on fairly solid ground in considering this to be irrational and worthy of addressing (via disputation if appropriate), particularly if it is contributing to deleterious outcomes. When a demand is clearly and legitimately conditional upon some other factor (“to win the gold medal I must win this race”) then there may be no case to answer. If we inaccurately and inappropriately try to address and dispute all utterances of the word ‘must’ we, are not practicing good REBT.
Second, practitioners gave their reflections on which irrational beliefs are particularly problematic for dealing with major setbacks. Again, depreciation beliefs appeared to be particularly salient for the practitioners, in part because the inevitable suffering (i.e., failure, illness, pain) that is indelible to performance settings creates a real problem if one defines oneself on the basis of these experiences. If I endorse the idea that I am “a loser” when I face a setback, or I am “weak and useless” when I become injured or are in pain, then this belief will appear very frequently because I will experience setbacks and pain very frequently. A broader point here is that performance settings are especially generative of adversity (concrete/actual, and inferential) and so irrational beliefs are highly salient. Frustration intolerance was also offered by the practitioners as a pertinent belief, and given that performance settings are adverse, intolerance of adversity is not a good solution for engaging with the performance environment or coming back from setbacks.
Tied to the above point is non-acceptance of reality and the lack of separation between the global self and the athlete self. If I completely define myself in line with my performance pursuits (“I am an athlete, that is everything I am”), and hold global evaluation beliefs such as self-depreciation (“I am a failure if I fail), within the context of ubiquitous adversity, then I am in precarious position as a performer with regards to my wellbeing. Once I face failure or injury, it is likely that I will experience an identity crisis on top of the suffering I am already enduring. As such, performers might be encouraged to accept that their performance environment is by nature adverse, and as practitioners we need to wrestle with the idea that an athlete with strong athletic identity, whilst laudably committed to their pursuits, might become victim to depreciation and the emotional turmoil that may bring.
Third, practitioners described the role of cognitive disputation in their applied work. This is important because one of REBT’s central change processes is underpinned by cognitive change. Predictably, practitioners recounted the importance of cognitive disputation using evidence, logic, and pragmatic disputes, but they also reflected on behavioural techniques. There was a sense from practitioner reflections that disputation is not just something you do with clients. Yes it is guided in the first instance, but more importantly, the client takes disputation skills with them and forms a foundation of rationality. The drive to enable clients to operate with REBT independently is important, and this includes helping the client to dispute in the real world, not just in the consulting room.
Practitioners also expressed, in line with an REBT approach (DiGiuseppe & Doyle, 2019), that mere insight into irrational beliefs and the ‘ABC model’ is not enough for deep change to occur – there was a sense that disputation was the ‘business end’ of the REBT work. However, disputation does not need to be laborious or even explicit. Disputation can be applied during a flowing interaction with a client as a way to help them shift their perspective on many matters – not just irrational beliefs. The skill of disputation, or cognitive change more broadly, stretches beyond the confines of irrational and rational beliefs, and can be an important skill for critical appraisal of various situations and cognitions.

Conclusions

In sum, practitioners wishing to apply REBT within HPEs are encouraged to be mindful of demandingness and depreciation in their clients. These beliefs appear to be particularly problematic and frequent in performance populations, as they undercut adaptive responses to the inevitable adversities that mark performance settings. Practitioners would be advised to limit the extent to which clients make their self-worth contingent upon performance results, and to help clients balance their perceptions of self, or global/total self, with their role related identities. Finally, practitioners should spend time and effort developing their ability to apply effective disputation with clients in performance settings. Disputation should be viewed not just as a cognitive task that takes place in the consultancy room, but rather, as a foundational skill that clients can harness to enable them to embody a rational philosophy of life.

Declarations

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.
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Metagegevens
Titel
At the Coalface: Practitioner Perspectives on Applying Rational Emotive Behaviour Therapy (REBT) in High Performance Sport
Auteurs
Martin J. Turner
Nanaki J. Chadha
Helen Davis
Muhammad S. Deen
Hugh Gilmore
Jennifer K. Jones
Scott Goldman
Mark Terjesen
Publicatiedatum
31-05-2022
Uitgeverij
Springer US
Gepubliceerd in
Journal of Rational-Emotive & Cognitive-Behavior Therapy / Uitgave 2/2023
Print ISSN: 0894-9085
Elektronisch ISSN: 1573-6563
DOI
https://doi.org/10.1007/s10942-022-00461-3

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