Psychological Effects of Sport Injury on NCAA Division I Student Athlete: A Qualitative Case Study

Negative emotional states are common for injured athletes, yet a 2016 survey suggested that only 38.3% of NCAA institutions had a full or part-time mental health professional (Kroshus, 2016). In considering the lack of support for mental health conditions in NCAA institutions, and the mental and psychological issues that come with injury, there is a gap in the psychological treatment of injured student athlete. To date, the extant literature suggests that sport medicine professionals (SMPs) play a critical role in the psychology of injury recovery, yet lack formal training in psychological interventions (Clement et al., 2013). Moreover, research examining athlete and SMPs experiences of the psychological aspects of injury rehabilitation is largely limited to retrospective accounts (e.g., Clement et al., 2015; Tatsumi & Takenouchi, 2014). The purpose of the current study was to prospectively examine the psychological challenges of injury rehabilitation in an NCAA athlete. A qualitative case study grounded in narrative methodology, and an interpretive epistemology, was conducted (Smith, 2009). Research interviews were conducted with an injured athlete, the athlete’s SMP, and a member of the athlete’s social support team at baseline (i.e., post-injury and prior to the start of rehabilitation) and during the rehabilitation process before the sport-specific phase. Additionally, the athlete kept a journal to document the psychological and emotional struggles that took place during the rehabilitation process. Data analysis was iterative through each phase of the study and followed Polkinghorne’s (1995) seven stages of narrative analysis. Results suggest that issues with identity are central to the injury-rehabilitation-return to play process. Notably, data suggest an ongoing struggle between the loss of identity in the present, the fear of identity loss in the future, and a desire to maintain a positive outlook on current circumstances, and ongoing tensions between cognitive appraisals and emotional reactions. The work of SMPs and sport psychology professionals working with injured athletes seems to be highly linked to the cognitive appraisals and behavioral responses and emotional responses respectively. While cognitive appraisal and behavioral responses seem to be congruent, cognitive appraisals and emotional responses appear to lack this dynamic. Suggested in this case, psychological interventions (specifically support groups) seem to be helpful in working through emotional stresses that come up throughout the rehabilitation process