Using self-help interventions

Athletes crave interventions that improve performance. Finding an intervention that works could involve working with a professional sports scientist or following a self-help package. Recent years has seen a rapid growth in the popularity in self-help interventions. Andy Lane offers guidance on how to use self-help interventions to improve performance.

The nature of sport is that individuals strive to find methods to improve performance. Commercial activity to meet this demand has led to increased availability of products such as sports drinks, supplements, equipment modification and numerous self-help books. In this article, I focus upon the use of self-help materials designed to give an athlete a psychological edge. However, at this juncture it is worth noting that physiological, biomechanical, technical and nutritional factors tend to work in tandem with psychological ones. Thus, anyone considering using a self-help intervention should remember that changing one aspect of performance could influence another. For example, in my experience with endurance athletes, interventions that bring about improvements in physiological indices that athletes see as important (lactic threshold, Vo2) are coupled with improvements in psychological ones.

What is a self-help intervention?

An intervention occurs in a number of different ways. In other contexts, we might see a different term being used. For example, if you are feeling ill you could book an appointment at your local General Practitioner (GP). Alternatively, if you have had the illness before, and believe you have correctly identified it, you could take an over-the-counter medication. You would judge the success of the intervention (medication in this instance) by judging whether you no longer feeling ill. In the interventions described in this article I use a similar model;

1. Identification of the problem

2. Implementation of the intervention and establishment of criteria for judging effectiveness

3. Assessment of its effectiveness

In the example above, the need for the intervention is signalled by feeling unwell. The intervention is the treatment or, in this case, medication. The assessment of effectiveness is whether the person no longer feels unwell. However, in sport psychology, the problem itself can be difficult to identify; an athlete might want to perform better but knowing which parts to work on is complex. In addition, assessing the effectiveness can be difficult, especially as psychological data tend to be subjective, an issue exacerbated by the fact that following a self-help intervention, you are both the client and consultant.

Self-help interventions and sport psychology: do they work?

There is an extensive literature that describes how to use self-help sport psychology interventions (1). I have contributed to this literature including authoring 17 Peak Performance articles (see www.pponline.com), each one offering self-help advice. How do I know if this is good advice? How do I know if the interventions I propose work?

First, the intervention should be supported by theory and tested scientifically. What a scientific study can tell us is whether an intervention has worked or not. An individual should rightly ask the question: “if following intervention X improves performance, then how much should I expect to improve after following it?” The key point is that when considering whether to use a specific intervention, an individual should look for supporting evidence.

The evidence supporting the use of self-help psychological interventions is strong and not restricted to sport (2). In clinical psychology, patients that followed an online self-help intervention for the treatment of anxiety and depression recovered as effectively as patients that worked with a therapist. In education, students who used self-guided online materials learned as effectively as students taught by attending traditional lectures (3). In social psychology, participants following a self-help intervention successfully learned to manage anxiety experience before giving presentations (4). And in health psychology, self-help interventions have helped people manage cravings when following diets (5). In sport psychology, self-help interventions successfully led to runners not only experiencing more pleasant emotions but also performing better (6). In summary, there is evidence demonstrating that self-help interventions work.

So how do I develop an effective self-help package?

Sir Dave Brailsford coined the phrase “the aggregation of marginal gains". He suggested that intervention work should involve systematically identifying each small part that contributes to performance, and then implement an intervention to change these, because collectively they can make a large difference. The repeated success of GB cycling in the Olympics bears testament for this approach. Of course, GB cycling had a whole team of technical experts, coaches sport scientists and sports medics to help identify where those margins could be gained. The question an individual following a self-help intervention should ask her or himself is; "how do I identify where gains can be made"? With self-help interventions, the individual is also a consultant, and therefore, it is important to establish monitoring systems to enable identification of factors that appear to influence performance.

Can I use my training diary as a way of assessing whether an intervention is needed?

A training diary can be a very effective way of identifying which variables to target for intervention work. However, at least three factors influence the relative success of using a training diary to help guide interventions. First, the diary needs to capture important variables that influence performance and be open to the possibility that you are not assessing the right information. An individual following a self-help intervention needs to be open to new ideas and continue reading widely. The individual is both the client and the consultant, and we expect consultants to be professionals who keep up with the latest research.

Second, how will you analyse data from your training diary? With the data sitting in front of you, the key question is "how do I make sense of it so that I know how my performance can be improved"? When deciding what data to record, you should also consider what you will do with it. If you record time spent training then presumably you will use this information to gauge whether it was useful in helping you achieve your goal? If you believe that running long periods of time, or completing certain distances, will help you achieve your marathon goal, then seeing that you are running for longer is likely to improve your confidence. However, if confidence is also influenced by the relative intensity of each run, and you realise that you are running for longer but at a lower intensity your confidence to be able to run at the high intensity on race day may not necessarily be increased. In the example above, the athlete should reflect on whether distance covered is truly a marker of progress with a suggestion that speed needs to be considered and recorded. The key point here is to have a strategy on how you will analyse data and how this will relate to the relative achievement of your goals.

A third factor to consider is that the act of keeping a training diary could be an intervention itself, particularly for helping manage unwanted emotions. Keeping a diary where you detail intense emotional experiences has been found to be an effective self-help strategy (7). Expressive writing is proposed to help process information better, and help restructure information from these experiences in a way that if such a situation arises next time, then they are better coped to deal with it (7).

Putting into practice

Assessing the important variables

Training diaries for endurance athletes are aided by the use of modern technology. You can get satellite navigation technology on your mobile phone with numerous free apps available to help record and collate training. In this regard technology has provided a huge advantage in that it takes away potential biases deriving from inaccurate measurement. Further, all you need to do is put on the device, and press start and stop to record training. Youdo not need to write down what was done which brings in issues to do with the accuracy of recall especially if you do not record what was done shortly after the session.

In addition to this type of data, I also suggest recording daily mood. Mood is a useful way of recording how well you are coping with training demands (8). Mood can be used to help balance your training so that you are recovered sufficiently so to maintain quality. Figure 1 depicts a mood diary of a fatigued athlete where the proposed intervention is recovery.

Figure 1: A simple emotion diary for a fatigued athlete

Mood	Not at all	A little		Moderately	Somewhat	Very much so
Anxious					L
Calm		L
Happy		L
Sad					L
Dejected				L
Energetic	L
Fatigued						L
Excited		L
Still					L
About your emotions
How did it influence my thoughts?			“I have been really lethargic today and just really sluggish. It’s the last day of a few days hard training, and I know I should have toughed it out before the rest day”.
How did it influence my thoughts and actions?			“Initially felt rubbish and wanted to stop; now feel guilty because I did not train hard enough; have to stop myself from training tomorrow because my head knows I should rest, but I am driven to go faster and can’t get the fact out of my head that missing training will cost places”

As seen in Figure 1, I would also record thoughts and feelings on how training went and what specific factors you feel influenced your mood. As indicated previously, expressive writing (7) has been found to be an effective intervention strategy. By exploring the likely cause of unwanted emotions, you also begin to develop a blueprint that helps you recognise situations which bring these and therefore provide opportunities through which to choose a different path to act in the future. For example, if speaking to competitors on the start line gets you particularly nervous, or their banter evokes anger which in turn affects your race strategy, then recognising this to be the case might help change your decision on where to warm-up. You could warm-up alone or rather than warming up near your competitors, and if situational factors prevent this, then listening to music via headphone can serve to block out their conversations.

Experimenting and revising

An important aspect of any intervention is to estimate the size of the potential benefit. It is important to recognise, or have identified how this benefit will be realised before starting the intervention. If for example, you choose to use imagery prior to competition, then it helps to identify what you wish to gain from using it. Many athletes will reply that the purpose of using intervention is to improve performance, and therefore the athlete should reflect on the relationship between imagery use and individual performance. However, improved performance as a criterion for judging the success of an intervention is little open and potentially vague. It helps to ask further questions on how it will help performance, and specifically, where should benefits be identified. An example of how this process works can be seen in Figure 2.

Figure 2

Following an intervention to improve performance:

Intervention	What was the goal	Did it work Yes or No	Comments /reflection
Week 1: Use imagery before starting to improve performance	Run faster over 5km	No. I ran the same time but slowed at the end.	Data shows I slowed down badly; or I went off too fast at the start. I felt great at the start- really focussed, maybe I need to revise my imagery to consider my pacing strategy. Imagery seemed to help me run faster at the start, but I could not sustain this.
Week 2: Revise imagery to focus on pacing and running smoothly.	Run faster over 5km but paying attention to pacing	Yes, partly worked.	Data shows I still slowed down, but my overall speed was faster. I did not slow down so much at the end. The issue here is to develop something to prevent slowing down at the end.
Week 3: Revise imagery to continue to focus on running smoothly, but now add using imagery at the point when fatigue begins to build to image an object associated with smooth running technique – in this case, a rotating train wheel.	Run faster over 5km but paying attention to pacing; and using imagery at the point when pain begins to build.	Yes	Smooth start; imagery and its effect now understood. Imagery helped cope with intense pain and managed to hold off slowing down until the later stages, and then managed a final effort for last 200m.

Summary

Self-help interventions can be as effective as consultant led ones; however, self-help interventions require the athlete to develop sophisticated methods of monitoring but in terms of judging what to record and also whether the intervention was successful. Training diaries should be used in conjunction with recording objective data in terms of distance and time spent training. Expressive writing is not only a helpful way of identifying issues stemming from training but also acts an intervention in itself. Reflect on what was done, whether it worked or not should be recorded, and this is information can be used to guide revisions to intervention strategies in future.

Andy Lane

Sport psychology professor, University of Wolverhampton, UK

References

1. Inside sport psychology, Champaign, IL: Human Kinetics, 2010

2. Clinical Psychological Review 2006; 13, 169-186

3. Elements of Quality Online Education, Practice and Direction, Needham, MA: Sloan Center for Online Education, 13-45, 2003

4. Journal of Consulting and Clinical Psychology 2011; 79: 123-128

5. Personality and Social Psychology Bulletin 2008; 34: 381-393

6. Journal of Sports Science and Medicine 2011; 10: 400-407. www.jssm.org/vol10/n2/22/v10n2-22pdf.pdf

7. Psychological Science 1997; 8: 162-166

8. The Sport and Exercise Scientist 2011; 29: 14-15. www.bases.org.uk/BASES-Expert-Statements