American Psychological Association Symposium sponsored by Div. 6 and 47
Integrative Sport Psychology
Integrative Athlete Assessment and
Interventions:
A Field-Tested Protocol
Roland A. Carlstedt, Ph.D.
Integrative Psychological Services of NYC
American Board of Sport Psychology;
Capella University: Harold Abel School of Psychology
I. Critique of Prevalent Athlete Assessment and
Intervention Approaches:
•
Mired in a stagnant paradigm based on weak data and even myth
•
Assessment and Intervention approaches are antiquated
•
Indiscriminately administered
•
Administered en masse’
•
Administered outside the realm of a coherent and integrative theoretical context
•
Little is known about athlete responding and propensities
•
Yet interventions are prescribed as though we really do
•
Assessment and Interventions merely for the sake of doing something
•
Failure to consider potent individual measures that have been shown to meditate:
ATTENTION, PHYSIOLOGICAL REACTIVITY and COGNITION
Despite promising theories of peak performance little if
any progress has been made in:
•
establishing group and individualized norms for attention,
•
physiological and cognitive responding.
•
developing standardized and ecologically valid protocols designed to
measure and manipulate attention, cognitive processes and physiological
responding.
•
operationalizing and measuring psychological performance (e.g., Zone, or
Flow states) beyond the level of self-report.
•
isolating potent and ecologically valid outcome measures.
•
creating psychological performance statistics allowing for reliable efficacy
studies.
•
widespread utilization of sophisticated procedures and instruments to gain
better insight of athlete performance.
II. Consequently, I advance the perspective that:
• we must systematically investigate athlete responding in more
ecologically valid competitive and training situations and
longitudinally.
• the efficacy of an intervention must be established at the level of the
individual athlete.
• individualized and normative databases need to be developed to
guide and amend mental training efforts.
• practitioners must acquire greater knowledge of individual athlete
responding.
• this latter endeavor should be a priority, superseding intervention
attempts that all too often are applied haphazardly, without
documentation and unequivocal demonstration of efficacy.
•
the practice of performance enhancement should be predicated on knowledge
and not anecdote or conjecture.
•
the failure to take athlete assessment and interventions to the next level will
leave our field in the dust, mired in a stagnant paradigm that eventually will call
the credibility of Applied Sport Psychology into question.
•
it is no longer tenable to ignore or not engage in empirically based and
systematic approaches to athlete assessment and interventions.
•
while the field has produced a significant body of quality research, much of it
stands alone, offering little practical guidance to practitioners that will assist
them in engaging in a more sophisticated and scientific approach to applied
sport psychology.
•
the time has come to consider a new multidimensional and integrative
approach to athlete assessment and interventions, one that utilizes
sophisticated instruments, normative databases and empirically-based
procedures to better assess athletes and document and analyze the effects of
interventions on psychological performance.
III. The protocol that I will present emanates from
research on the Theory of Critical Moments.
•
The Theory of Critical Moments Proposes that:
•
Peak performance and mastery, as well as failure, is mediated by
interactions of specifically isolated PRIMARY HIGHER ORDER (PHO)
traits and behaviors that have been shown to be intimately linked to
attention, physiological reactivity, cognition and motor performance,
especially during crucial phases of competition, or CRITICAL MOMENTS
when the impact of these measures will be the greatest.
•
Consequently, interventions must consider an athlete’s constellation of PHO
factors and temporal gradients associated with their administration to be
effective.
•
These measures include Hypnotic Susceptibility/Absorption, Emotionality
(negative/positive affect; neuroticism) and Repressive Coping.
• Hypnotic Susceptibility (HS) is a psychophysiological
trait that can manifest itself independent of hypnosis
or hypnotic induction. It is a pervasive and
omnipresent mode of information processing marked
by intense focus on internal or external stimuli as well as
surplus pattern recognition. I refer to hypnotic
susceptibility as the ZONE or FLOW facilitator in that it
is associated with similar descriptors that have been
used to describe peak performance states, including
intense concentration/focus, effortlessness,
involuntariness, dissociation and freedom from
distraction. HS can, however, be a double-edged sword
in that intense and effortless focus can rapidly shift from
stimuli to stimuli dependent upon a person’s concurrent
levels of neuroticism and repressive coping.
• Emotionality, or negative/positive affectneuroticism is a BIG-5 personality dimension
that mediates a person’s reactive tendencies
to internal and external stimuli. Negative affect is
associated with a catasptrophizing cognitive
style and excessive levels of physiological
reactivity even at baseline in the absence of
apparent stressors or perception of threat.
Negative affect/neuroticism can be thought of as
the great disruptor of ZONE or FLOW states.
• Repressive coping is a behavioral propensity
characterized by the ability to ignore negative internal
and external stimuli and cognitions as well as pain and
physical symptoms. It is associated with enhanced selfesteem and confidence. Neurophysiologically, this
measure has been shown to functionally disconnect
the interhemispheric transfer of negative affect from
the right to the left-brain hemisphere, which is thought
to prevent intrusive cognitions from reaching
consciousness and disrupting performance. As such,
repressive coping can be viewed as the great
moderator of ZONE or FLOW states.
Emerging Evidence
– Constellations and/or interactions of these measures
have explained up to 44% of the variance in the
performance equation that can be attributed to
psychological factors, as a linear function of
increasing level of critical moments, an
unprecedented finding. In other studies from the
realm of behavioral medicine and clinical psychology
up to 65% of the variance in a variety of clinical
outcome measures related to attention, physiological
reactivity, cognition, symptomology and treatment
efficacy has been accounted for on the basis of
constellations, interactions or individual measures in
the above triad (Carlstedt, research in progress).
VARIANCE EXLAINED AS FUNCTION OF LEVEL
of Criticality of a Competitive Moment
IV. Neuropsychophysiological Dynamics of PHO Factors
V. Implications of Findings and the Theory of Critical
Moments for Assessment and Interventions
•
–
PHO factors appear to be crucially involved in mediating performance.
–
Findings from research are consistent with predictions from the Theory of
Critical Moments and in line with the neurophysiological and
psychophysiological dynamics advanced by this model.
–
It should also be noted that these findings are also consistent with
components of Dietrich’s Transient Hypofrontality Hypothesis.
–
Neuropsychological, neurophysiological and cardiovascular
psychophysiological measures are expected to not only reflect baseline
states of reactivity or activation but also the effects of interventions. They
are also hypothesized to reflect Zone or Flow states.
–
Consequently, assessment and intervention strategies that are designed to
document, predict and enhance performance need to address the above
measures within a comprehensive and integrative athlete assessment
and intervention battery.
VI. The Carlstedt Protocol
• Step-by-Step Overview:
• Assessment of PHO factors, Relative Cortical Activation and
Neuropsychological/cognitive tendencies
• Instruments/tests: Stanford Scale of Hypnotic Susceptibility;
Tellegen Absorption Scale; Positive Affect/Negative Affect Schedule
or Eysenck Personality Inventory; Marlowe-Crowne; Line-Bisecting
Test (Drake Paradigm); Brain Resource Company Neurocognitive
Battery for Athletes (Internet based test, analysis center and
database).
• Off-the-field Psychophysiological Stress Test
• Instruments: BioCom Technologies Heart Rate Monitoring Hardand-Software; Heart Rate Variability Software
•
On-field HRV/HRD Analysis
•
Instruments: Biocom Technologies/Brainquiry/Carlstedt “HEART
MINDER” ambulatory heart activity monitoring and biofeedback
device; BioCom Technologies/Carlstedt Heart Rate Deceleration
Software; BioCom HRV Software.
•
On-field HRV/HRD Analysis with Critical Moment Analysis
(CMPPQ)
•
Post Competition Data Analysis
•
Instruments: Heart Minder Internet Based Analysis and
Database Center
• Intervention Selection- Pre-Competition and
On-the-Field
• Efficacy Testing-Intervention
• Mental Training using most efficacious
Intervention
• Continual Monitoring-Data Bank
Rationale for Protocol Assessment and
Intervention Strategy
• The Carlstedt Protocol is based on an
initial assessment of PHO factors including
hypnotic ability/absorption, neuroticism,
repressive coping and relative cerebral
laterality. Establishing a benchmark
profile predicting psychophysiological
propensities.
• Once an athlete’s profile has been
established, psychophysiological testing is
used off and on the playing field. An initial
Psychophysiological Stress Test (PST) is
administered to determine if
physiological reactivity in the
laboratory/practice is consistent with
what would be expected on the basis of
an athlete’s constellation of PHO factors
and cerebral laterality.
• Thereafter, heart rate variability/heart rate
deceleration responses are measured
during both training and actual competition
while analyzing physical/technical, tactical
and statistical performance using the
Carlstedt Critical Moment
Psychological Profiency-Index
(CCMPP-I) statistical analysis system for
evaluating psychological performance
during competition.
• Assessment of physiological responding
and psychological performance during
actual competition are done in attempt to
validate concurrently PST responses
on the field. It is also carried out to
determine the predictive validity of an
athlete’s PHO factors relative to on-thefield performance and physiological
responding.
• Once a trait-like profile of
psychophysiological
reactivity/responsivity is established on
the basis of longitudinally acquired data (at
least 3-5 complete measurement
occasions) interventions are selected and
implemented to modify responding in the
desired direction.
INTERVENTIONS INCLUDE:
– Neurofeedback and on-the-field Manipulation of Cortical
Activation
– Heart Rate Variability, RSA and EMG Biofeedback with
Stimulus Manipulation (e.g., video viewing)
–
RSA Biofeedback on-the-field
–
Active-alert hypnosis
–
Recovery hypnosis
–
Mental Imagery
–
Cognitive intervention
• An important component of the Protocol
is efficacy testing of interventions using
the CCMPP-I system to determine the
extent to which an intervention
influences outcome (physical/technical,
tactical, physiological or statistical
success/won-loss outcome measures).
• If an intervention appears to be
ineffectual, it is usually supplanted with
an alternative method until an ideal
mental training modality is found.
Thereafter, mental training is routinely
engaged in as a prophylaxis in an attempt
to optimally prepare an athlete for
competition.
• Mental training during actual competition
includes affect monitoring and altering using
cerebral laterality manipulation to activate the
left-brain hemisphere prior to action (gaze
manipulation, etc.) and during time-outs (linebisecting test and PANAS schedule).
• Whenever possible, athletes are also monitored
during actual competition and training.
• The acquired data are then analyzed, discussed
with the athlete and coaches and stored.
Rationale for Applying an
Intervention
• The rationale for applying a specific
intervention to an athlete can be traced to
the research on the Theory of Critical
Moments and Wickramasekera’s High
Risk Model of Threat Perception (1988)
This research suggests that persons
possessing specific PHO factors were
more or less amenable to certain forms
of treatment. Specifically it is proposed
that:
• 1) Persons high in hypnotic
ability/absorption who are more fantasy
prone and imaginative compared to lows
were found to benefit more from hypnosis
and imagery-based interventions than
therapies that are more reality based, such
as rational-emotive psychotherapy and
biofeedback.
• SINCE A HIGH MAJORITY OF ATHLETES
HAVE BEEN FOUND TO BE LOW IN
ABSORPTION AND HYPNOTIC
SUSCEPTIBILITY, MENTAL IMAGERY, THE
MOST WIDESPREAD INTERVENTION MAY
BE AN INTERVENTION THAT MOST
ATHLETES WILL NOT BENEFIT FROM
UNLESS ADMINISTERED IN THE CONTEXT
OF INDIVIDUALIZED PROTOCOLS THAT
CLOSELY MONITOR AND ANALYZE ITS
EFFECTS.
• 2) By contrast, individuals that are high in
repressive coping who are more
skeptical and reality-oriented than lows,
benefited more from biofeedback, a
modality providing objective feedback
about mind-body interactions they would
otherwise not believe or tend to ignore.
3) Those who were low in hypnotic ability/absorption
were less likely to benefit from hypnosis and imagery
and instead were also more likely to benefit from
biofeedback, whereas individuals low in repressive
coping were found to be more amenable to hypnosis
and imagery provided that they were not also low in
hypnotic ability/absorption.
Individuals exhibiting a more rare constellation of high
hypnotic ability/absorption and high repressive
coping were considered good candidates for both
hypnosis/imagery and biofeedback.
An Appeal to Practitioners
In this era of high-technology replete with
psychophysiological monitoring devices and
sophisticated computer analysis, it is no
longer tenable to administer interventions
that have not been tested for reliability,
validity and efficacy.
All Sport Psychology practitioners should be
trained in psychophysiology and
biofeedback and equiped to monitor and
assess the psychophysiology of athletes and
teams or access consultants who are
Contributing to the Development of a
New Paradigm in Assessment and
Intervention
• An Internet-Based Athlete Assessment,
Analysis, Intervention and Database Center:
Your Personal Sport Psychology Consultant
and Researcher
Why is there a need?
• Speculative comments, analyses and
advice regarding the mental side of the
game are just as common among Sport
Psychologists as they are among the laity.
Psycho-babble or the Basis of a
Scientific Sport Psychology?
• mental toughness, motivation, focus,
zone, mental training “just do it,” etc.
• Although the above constructs and
notions may indeed form the basis of
certain aspects of sport performance
when used in the context of poppsychological analyses, they are
wanting as to their meaning.
• Essentially, the field of Sport
Psychology has fed these meaningless
slogans, platitudes and notions to the
masses, such that coaches, athletes
and analysts have bought into many
myths and methods advanced by the
field as though they are the GOSPEL!
• However, without systematically
delineating the mental components of
the performance equation and
operationalizing the pet slogans of
Sport Psychology, coaches, athletes,
teams and analysts have little of
empirical value to draw on and utilize
when it comes to making decisions
about athletes
• In contrast to the physical and technical
game about which there is an abundance
of scientific information and data along with
huge volumes of actual objective
performance statistics (especially in the
sports of baseball, football and basketball),
when it comes to the mental side of the
game, there is a paucity of valid and reliable
information about its dynamics.
• Consequently, potentially revealing
measures such as “zone,” “focus,” and
“mental toughness” have devolved
instead of evolving into potent
constructs and sensitive measures of
psychological performance. They have
become misused and even abused
terms that are thrown about with
impunity. At face value they mean
nothing.
• Essentially, the assessment of
psychological performance, mental
training and ultimately decision making
regarding an athlete’s mental game and
predictions of future performance are
often based on anecdotal speculation
instead of good science.
• If the field of Sport Psychology is to make
inroads into professional sports and provide
all athletes the best possible service and
methods a paradigm shift pertaining to the
assessment and mental training needs to
occur. It must be based on rigorous scientific
approaches and methods, similar to those
seen in the clinical realm where major
advances have been made pertaining to
patient diagnosis and treatment.
• New approaches to athlete evaluation
must produce meaningful and useful
information regarding an athlete’s
psychological performance that has a
high degree of validity and reliability.
• Just as a professional scout or coach knows
an athlete’s vertical jumping ability, foot
speed, performance average, technical
propensities, body-fat index and oxygen
uptake, the time has come to develop
individualized normative databases on
psychological and
neuropsychophysiological functioning in
athletes for assessment, comparative and
intervention purposes.
• Practitioners should know an athlete’s
“attention threshold,” “brain processing
speed and reaction time,” “emotional
reactivity,” “critical moment psychological
proficiency,” “heart rate variability and
deceleration response parameters,” and
“movement related brain-macro potential
readings” among other important
performance components if they are to
effectively advise athletes, coaches and
teams.
• The era of merely telling athletes “to relax” or “just
imagine” or “shut out all negative thoughts” is
passé. A new era needs to emerge in which slogans
like “just relax” are operationalized in terms of
“generating more high frequency heart rate
variability” prior to critical moments, or increasing
“focus” would involve engaging in neurofeedback to
achieve a higher attention threshold. Rather than tell
an athlete to “shut out negative thoughts,” athletes
would be taught to manipulate relative brain
hemispheric activation to suppress intrusive
thoughts.
• The current cliché laden “just do it”
approach needs to be replaced with methods
that define many of the nebulous constructs
that pervade Sport Psychology today. It is
time to delineate Hanin’s (1980) theory and
postulates using instruments and
methodologies that allow us to measure the
states of intensity or physiological reactivity
to which his theory refers.
• It is no longer tenable for ANY practitioner
delving in the arena of Sport Psychology to
speak in nebulous terms such as “he doesn’t
concentrate” or “she’s a choker,” or “he’s
not mentally tough” or recommend
interventions just because they are the thing
to do. “You’ve got to visualize” or “get your
intensity up,” as slogans to somehow
involve a person in mental training are
insufficient.
• Athletes and coaches need to be provided
with standardized measures and parameters
of sport relevant psychological and
neuropsychophysiological functioning. The
time has come for practitioners to use new
language that is based on empirically derived
data and operationalizations of
psychological processes and their effects on
performance.
• Advanced technology and
methodologies are available to lift
Applied Sport Psychology to a new
level of sophistication and credibility,
they just have to be used.
The Athlete Neuropsychophysiological Performance
Database Project and Internet-based Psychological
Assessment and Performance Center
• While I recognize that most practitioners do
not have specialized training in
Psychophysiology, Neuropsychology and
ambulatory assessment and monitoring the
advent of chip technology has given rise to
numerous products that can be used by
practitioners, coaches and athletes. These
devices can be used to gather data, analyze
it and even entrain ideal
neuropsychophysiological states at home
and more recently on-the-field.
• Consequently, I am advocating that ALL
Sport Psychology practitioners participate in
an international, controlled and standardized
protocol designed to create a normative
database of neuropsychophysiological
functioning in athletes for off-the-field
baseline conditions and tasks, on-the-field
during real training and competition and
during critical moments of competition. The
project is multifaceted and will be easily
accessible to practitioners and athletes.
• Central to the NPAD project is the Brain
Resource Company (BRC)
neuropsychological test battery and
quantitative electroencephalography (qEEG)
brain functioning analysis protocol. In the
clinical world, the BRC approach to the
establishment of normative brain databases
is emerging as one of the most valid and
reliable indices of cortical functioning,
primarily because of the rigorously
controlled and administered protocol the
BRC adheres to.
• As the athlete-specific database evolves it is
expected that clear tendencies in brain
functioning will emerge that will distinguish
athletes in terms of psychological
performance and that some of the findings
and hypotheses on cortical functioning in
athletes that I present in my new book will be
concurrently validated on the basis of
multiple neurophysiological measures and
markers the BRC protocol captures.
• The BRC approach is also intended to
flexible and dynamic and will evolve to
include new measures of athleterelevant cortical functioning on the
basis of the initial database findings.
An in-the-field database
neuropsychological protocol will also
be developed in phase II of the BRC
project.
• The APAPC project is an applied field
study approach to the assessment and
evaluation of athletes. It is separate
from the BRC database project, yet
complimentary and predicated on the
ecological validity of monitoring
procedures and data generation.
• Participating practitioners or individual athletes will
have access to a new and sophisticated ambulatory
monitoring device that was jointly developed by
BraInquiry, Biocom Technologies and myself. The
device is capable of monitoring various measures
including heart rate variability, EEG, Galvanic Skin
Response, EMG-muscle tension. The APAPC project
will primarily focus on HRV using an adapted version
of the BraInquiry Personal Efficiency Trainer (PET)
containing BioCom Technologies’ advanced HRV
analysis software, called the Heart-Minder.
• This device is capable of acquiring continuous data
for up to eighteen hours and can be used during
training and competition to assess and enhance
psychological performance. The Heart-Minder is
linked to an internet-based data analysis center.
Participants in this project will upload data to the
internet data center for analysis and report
generation. Acquired data will also be used to extend
on my own and BioCom Technologies’ existing HRV
and heart rate deceleration databases for athletes,
normal and clinical samples.
• Practitioners and athletes will receive a
customized report along with
recommendations for mental training
and comparative norms. Practitioners
who are specially trained in this
protocol will also have access to
personal computer-based analysis
software for in-office evaluation and
mental training purposes.
• The advent of the Heart-Minder, PET and
internet data analysis center go a long way
toward removing barriers associated with
ambulatory monitoring and high-tech
assessment of athletes (see Carlstedt, 2002).
The device is quite small, powerful in its data
acquirement and analysis capabilities and is
linked to a professional support team and
center. Moreover, the device has biofeedback
capabilities that allows for in-the-field mental
training and self-regulation interventions.
• The BRC protocols allow for highly valid and
reliable analyses of brain functioning that is
relevant to sport performance. The BRC
brain analysis battery includes measures of
executive functioning, subliminal cognitive
and emotional processing, responding and
reaction time tasks measured at the level of
the brain, comprehensive EEG activity
(qEEG) and central nervous system reactivity
to select stimuli.
• Although such a high-tech approach to athlete
assessment and intervention may seem complex
and inaccessible to the average practitioner, it need
not be and thus should be sought by any
professional sport organization, coach, athlete or
practitioner who is serious about the psychological
side of the game. It is inexcusable and perhaps even
unethical for practitioners to continue to advocate
and use a paradigm that does not test its methods
for efficacy or use the most advanced and
sophisticated approaches available. One can think of
issues of practice and competency using the
following analogy.
• For example, if a Psychologist or Psychiatrist in the
course of routine therapy, upon hearing that a
patient had chronic headaches, merely dismissed
the complaint and failed to refer the patient for
further assessment from a Neurologist, he or she
would be considered negligent and liable were the
patient to die of a brain tumor. Just because a
practitioner does not have access to an MRI
machine, let alone know how to use it or evaluate a
brain scan, doesn’t mean he or she should not seek
out experts who use this advanced technology.
• Similarly, just because a practitioner does not have
high-tech equipment to assess brain functioning or
heart rate variability in athletes or do efficacy
studies on applied interventions does not mean he
or she should not seek out specialists who can. The
argument that it is not necessary to validate the
effects of interventions or basic assessments in
athletes is becoming increasingly tenuous as more
research comes to light attesting to the utility and
benefits of advanced and technologically
sophisticated assessment, monitoring and mental
training methods.
• The above multifaceted and high-tech
approach to applied Sport Psychology
offers athletes, coaches and teams
access to cutting edge scientific
methods and technology that will
illuminate psychological performance
as never before.
• Interested practitioners and athletes are
invited to participate in this internet database
and analysis project. Doing so will help the
field of Sport Psychology generate normative
data on the psychological performance of
athletes as well assist practitioners in
providing coaches and athletes the most
advanced approach to assessment and
mental training intervention available.
• For more information on this project please visit
the American Board of Sport Psychology website
at: www.americanboardofsportpsychology.org. A
portal or link to the project website can be found
there.
• You can also email Dr. Roland A. Carlstedt at
DrRCarlstedt@aol.com or contact or call 212860-8500 (ext. 25) or 917-680-3994 to learn how
to participate in this groundbreaking project.
References
• Carlstedt, R.A. (2004). Critical moments during
competition: A mind-body model of sport performance
when it counts the most. NY: Psychology Press.
• Carlstedt, R.A. (2004) Line-bisecting performance in
highly skilled athletes: Does rightward error reflect
unique cortical functioning and organization. Brain and
Cognition, 54, 52-57.
• Wickramasekera, I. (1988) Clinical behavioral medicine.
NY: Plenum.
About the Author
• Roland A. Carlstedt, Ph.D. is a Licensed Psychologist and Sport
Psychologist. He directs Integrative Psychological Services of NYC.
His clinical specialties are Behavioral Medicine, Health Psychology
and Applied Psychophysiology and Biofeedback. Dr. Carlstedt is the
Director of Sport Psychology Research: Heart and Brain Processes
with BioCom Technologies and a Consultant to the Brain Resource
Company. He is a member of the Capella University: Harold Abel
School of Psychology and Chairman and Head Mentor of the
American Board of Sport Psychology. A former Professional Tennis
Player and Coach he worked on the ATP/WTA tennis tours fulltime
for over ten years. He is the recipient of the American Psychological
Association Division 47 2001 Dissertation Award. His dissertation
was also nominated for the Society for Neuroscience’s 2001 Donald
Lindsley Dissertation Award.