Today members attended an insightful and interesting CPD day which looked at the use and applications of CBT in sport psychology. Here is a video of what some of our members thought of the day.

A short video with some of the delegates discussing what they thought and what they learnt from todays CBT in Sport Psychology event. Thanks to @JHurley_ @petejackson and @Luke_Barnes_1 for agreeing to be on the video. @BPS_DSEP #CBTinSport pic.twitter.com/z29K6doYWk

— Matthew Cunliffe (@MattCunliffe24) May 7, 2019

For more information about CBT in sport psychology contact the event leader Matt Cunliffe

Dr Philip Hurst, Canterbury Christ Church University, @Phil_Hurst1

In this blog I aim to provide a short summary of the placebo effect and its potential to be used a tool to prevent drug use in sport. A brief introduction of the placebo effect on sport performance is provided and the implications this research can have for sport practitioners is discussed.

What is the placebo effect?

Over the past 50 years, research in sport and exercise science has shown the significant impact the placebo effect can have on sport performance. Linked to psychoneurobiological changes, placebo effects often result from the expectation or belief that an intervention will improve performance (Hurst, Foad, Coleman, & Beedie, 2017a). Typically, research in sport and exercise science investigates the placebo effect of performance enhancing substances (Beedie et al., 2018; Beedie & Foad, 2009), such as anabolic steroids (Maganaris, Collins, & Sharp, 2000), caffeine (Beedie, Stuart, Coleman, & Foad, 2006) and sodium bicarbonate (McClung & Collins, 2007). Collectively, this research suggest that the belief that a substance has been received can improve sport performance by up to 5% (Beedie & Foad, 2009).

Could you use a placebo in practice?

Given the significant impact placebo effects can have on sport performance, it is understandable for practitioners to consider using the placebo effect to improve their athletes’ performance (Beedie et al., 2017). In a survey study of nearly 100 coaches ranging from regional to international level, Szabo and Muller (2016) found that 44% of the sample indicated they had used placebos in the attempt to enhance their athletes’ performance, with international level coaches being the most likely to do so. Over half (58%) of the coaches indicated they would use a placebo again and among this group, 14% indicated they would do so without the athlete’s consent. The finding that a majority of coaches use placebos, often without the consent or knowledge of their athletes, and the willingness of athletes to use a purported performance enhancer on the advice of the coach describes conditions rife for the unethical use of the placebo effect in sport.

Implications of the placebo effect in practice

The benevolent and paternalistic use of the placebo effect is arguably contrary to individual autonomy, and if an athlete discovers they have used a placebo when they believed it was a performance enhancing substance, this may negatively affect the trust between the practitioner and athlete. The use of the placebo effect in practice is arguably unethical. However, research has shown that a significant proportion of the effectiveness of a performance enhancing substance, can often be the result of the placebo effect. In light of this, it has been suggested that placebo effect research could be used as a tool to prevent the use of banned performance enhancing substances (i.e. doping).

Could placebos prevent drug use in sport?

If it is demonstrated to athletes that placebo effects can affect their performance to a similar degree as performance enhancing substances, it is reasonable to suggest that athletes with this knowledge may be less likely to dope in the future. As part of my PhD, I aimed to determine whether knowledge of the placebo effect could affect athletes’ decision to use performance enhancing substances. Six hundred and twenty seven athletes were recruited to take part in a placebo effect experiment. After completing measures of intention to use and attitudes towards performance enhancing substances, athletes completed baseline 5 x 20-m sprints. They were then randomised to one of three groups. Group 1 were given a placebo and told it would improve performance, group 2 were given a placebo and told it was harmful sport supplement and group 3 were given nothing and told nothing. Twenty minutes later, athletes ran another 5 x 20-m sprints. After completing the sprints, athletes in groups 1 and 2 were shown the results of the sprints (see Hurst et al., 2017a) and told that they were not given a sport supplement, but in fact, were given a placebo. They were told about existing research in this area and that the belief that a substance has been received can significantly influence their performance. Group 3 were shown the results of the sprints and not given any information about the placebo effect. Athletes then completed measures of intention to use and attitudes towards performance enhancing substances once more. Results indicated that compared to group 3, athletes in group 1 and 2 were less likely to use performance enhancing substances in the future and reported less favourable attitudes towards doping.

The placebo effect and anti-doping

For practitioners aiming to prevent performance enhancing substance use in sport, educating athletes about the placebo effect may be beneficial. It has recently been shown that athletes believing sport supplements are effective, are more likely to dope (Hurst, Foad, Coleman, & Beedie, 2017b; Hurst, Kavussanu, Boardley, & Ring, 2019), and that athletes who intend to use supplements are more likely to respond to a placebo (Hurst et al., 2017a). It is therefore reasonable to suggest that educating athletes about the placebo effect might help athletes make more informed decisions about the use of performance enhancing substances and reduce the risk of athletes doping. Sport organisations, such as UK Anti-doping and the World Anti-Doping Agency, could include material in their anti-doping education programmes about the placebo effect to help mitigate an athletes likelihood of using potentially harmful performance enhancing substances.

Reference list

Beedie, C., Benedetti, F., Barbiani, D., Camerone, E., Cohen, E., Coleman, D., . . . Szabo, A. (2018). Consensus statement on placebo effects in sports and exercise: the need for conceptual clarity, methodological rigour, and the elucidation of neurobiological mechanisms. European Journal of Sport Science, 18(10), 1383-1389. doi:10.1080/17461391.2018.1496144

Beedie, C., & Foad, A. J. (2009). The placebo effect in sports performance: a brief review. Sports Medicine, 39(4), 313-329. doi:10.2165/00007256-200939040-00004

Beedie, C., Stuart, E. M., Coleman, D. A., & Foad, A. J. (2006). Placebo effects of caffeine on cycling performance. Medicine and Science in Sports and Exercise, 38(12), 2159-2164. doi:10.1249/01.mss.0000233805.56315.a9

Beedie, C., Whyte, G., Lane, A. M., Cohen, E., Raglin, J., Hurst, P., . . . Foad, A. (2017). ‘Caution, this treatment is a placebo. It might work, but it might not’: why emerging mechanistic evidence for placebo effects does not legitimise complementary and alternative medicines in sport. In: BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine.

Hurst, P., Foad, A. J., Coleman, D. A., & Beedie, C. (2017a). Athletes Intending to Use Sports Supplements Are More Likely to Respond to a Placebo. Medicine and Science in Sports and Exercise, 40(9), 1877-1883. doi:10.1249/MSS.0000000000001297.

Hurst, P., Foad, A. J., Coleman, D. A., & Beedie, C. (2017b). Development and validation of the Sports Supplements Beliefs Scale. Performance Enhancement & Health, 5(3), 89-97. doi:10.1016/j.peh.2016.10.001

Hurst, P., Kavussanu, M., Boardley, I. D., & Ring, C. (2019). Sport supplement us predicts doping via sport supplement beliefs. Journal of Sports Sciences, 1-7. doi:10.1080/02640414.2019.1589920

Maganaris, C. N., Collins, D., & Sharp, M. (2000). Expectancy effects and strength training: do steroids make a difference? The Sport Psychologist, 14(3), 272-278.

McClung, M., & Collins, D. (2007). “Because I know it will!”: placebo effects of an ergogenic aid on athletic performance. Journal of Sport and Exercise Psychology, 29(3), 382-394.

Szabo, A., & Muller, A. (2016). Coaches’ attitudes towards placebo interventions in sport. Eur J Sport Sci, 16(3), 293-300. doi:10.1080/17461391.2015.1019572

Jennifer Lace, BASES Sport Psychology Pathway, @lacey_jen

So its Wednesday, we don’t normally have football fixtures on Wednesdays, we don’t normally have many training sessions on Wednesdays at all, so why today? Why today are there academy squads in? match prepping? and lots of different coaches?

The day is perfect for us lucky enough to work in beautiful game and looking out on training ground the sun beats down with a small breeze. Then I see large vans, 2,3 no, 4 vans. All lined up alongside the pristine pitch. The Premier League have arrived with their Virtual Assistant referee (VAR) equipment. Wow, my naivety acknowledged here, I didn’t know video feedback required so much equipment. So today the Premier League are hosting a series of behind closed doors games (no spectators or scouts allowed) to use VAR and train their referees and we are the lucky club to host the games. (Side note here I actually experienced myself recognizing the new era of ‘celebrity referees’ that I have seen on the TV games-EEEEEK!).

So although not formally written, objectively measured, nor set out to be systematically investigated, there were lots of questions running through my mind as a psychology practitioner embarking on my learning journey; what impact would VAR have on the day? would our academy coaches change at all? What do the players think? Is anybody else in the building thinking this could be a great day to understand the effects of VAR from a psychological perspective?

With my mind boggling I watched the games, club staff and Premier League staff going about their performance roles. The day flowed well and everybody seemed enthused by the presence of all the vans the huge transmitting dishes. I started to ask the coaches some questions on their perspectives of VAR. The main discussion point made by the coaching staff was their feelings surrounding the effects of VAR on the momentum of the game. The coaches in youth development mentioned they teach game management; slowing the game down, speed the game up and in its broadest sense encouraging actions and behaviours which would produce psychological dominance over opponents. They highlighted how VAR could stop these concepts and change the game in an instance. Furthermore, the concept of controlling momentum was raised and how to coach players to understand which team has momentum. The youth development coaches’ mentioned that players are taught to ‘’feel the game’’ ‘’read the game’’ and ‘’control momentum’’, yet VAR can interject and redirect momentum at any point.  The overall concluding thought for the day was that VAR added another experience variable which development coaches now felt they had to consider and  incorporate into their the youth development pathway.

If you would like to hear more about Jennifer’s work in football and VAR follow her on twitter: @lacey_jen

Dr Amy Whitehead, Programme Manager in Sports Coaching, Liverpool John Moores University (@a_whitehead1 @ThinkAloudUK)

This blog aims to provide a snap shot of what Think Aloud is, how it has been used in research and how it can be used within an applied sport setting. It is hoped that this blog will give readers a flavor of the work that has currently been done and give researchers and practitioners some ideas of how to adopt this within their own practice.

Think Aloud protocol (Ericsson and Simon, 1993) involves asking a participant to verbalize his or her thoughts aloud whilst performing a task and has traditionally been used within psychology to understand how people process information during problem solving tasks. However, more recently within sport it has been adopted to understand decision making and athlete cognition in a variety of difference sports such as golf (Whitehead, Taylor & Polman, 2015; Whitehead, Taylor & Polman, 2016a), cycling (Whitehead et al., 2017; Whitehead et al., 2018), Tennis (Swettenham, Eubank, Don, & Whitehead, 2018), and Snooker (Welsh et al., 2018). Research within sport using Think Aloud protocol has been able to demonstrate differences between experts and novices. More specifically, how experts and novices will focus on different variables within their environment prior to, during and post completion of a task. In addition, through the use of Think Aloud, differences have been found between cognition occurring in practice in comparison to competition, which could explain why some athletes may perform worse under pressure. For example, Whitehead et al. (2016), found that during higher pressure situations (competition), higher level golfers verbalized more technical related thoughts in competition in comparison to practice. This has the potential to explain why some athletes may ‘choke’ under pressure.

Using this research and applying Think Aloud to the applied world of sport, coaches and sport psychologists have the potential to further their understanding of how athletes may process and attend to certain information at certain points during performance. For example, Think Aloud may be used to identify such situations (but not limited to) where an athlete repeatedly gets angry and in turn becomes distracted from the task in golf following an unsuccessful shot in golf. This may lead to a decrease in performance. However, the coach or sport psychologist, and even the athlete can use Think Aloud to record this behavior and appropriate interventions can be put into place to assist the athlete in emotional management and improved cognitive focus within the task.

Similarly, the process above has been used within a coach education setting. Whitehead et al., (2016b) used Think Aloud with Rugby League coaches. This project aimed to help coaches understand their own thought and coaching processes, with the purpose of improving coaching behavior. Through using Think Aloud whilst coaching and then listening back to their audio recordings, coaches were able to reflect on their own coaching processes, thoughts and behaviors and in turn become better coaches.

More research and applied work is still necessary to develop the use of Think Aloud within a wider range of sports and settings. However, it is hoped that this blog provides a small insight into how Think Aloud has been used and encourages researchers and applied practitioners to adopt this method.

If you want to find out more about Think Aloud check out Dr Amy Whitehead’s publications: https://www.ljmu.ac.uk/about-us/staff-profiles/faculty-of-education-health-and-community/sport-studies-leisure-and-nutrition/amy-whitehead if

References:

Swettenham, L., Eubank, M., Won, D., & Whitehead, A.E. (2018) Investigating stress and coping during practice and competition in tennis using think aloud, International Journal of Sport and Exercise Psychology, DOI: 10.1080/1612197X.2018.1511622

Welsh, J.C., Dewhurst, S.A., & Perry, J.L. (2018). Thinking Aloud: An exploration of cognitions in professional snooker, Psychology of Sport & Exercise, 36, 197-208. doi: 10.1016/ j.psychsport.2018.03.003

Whitehead, A. E., Cropley, B., Miles, A., Huntley, T., Quayle, L., & Knowles, Z. (2016b). ‘Think Aloud’: Towards a framework to facilitate reflective practice amongst rugby league coaches. International Sport Coaching Journal, 3, 269 – 286. 16

 Whitehead, A. E., Jones, H. S., Williams, E. L., Dowling, C., Morley, D., Taylor, J., & Polman, R. C. (2017). Changes in cognition over a 16.1 km cycling time trial using a think aloud protocol: Preliminary evidence. International Journal of Sport and Exercise Psychology, 1–9. 20

 Whitehead, A. E., Jones, H. S., Williams, E. L., Rowley, C., Quayle, L., Marchant, D., & Polman, R. C. (2018). Investigating the relationship between cognitions, pacing strategies and performance in 16.1 km cycling time trials using a think aloud protocol. Psychology of Sport & Exercise, 34, 95 – 109.

Whitehead, A. E., Taylor, J. A., & Polman, R. C. J. (2015). Examination of the suitability of collecting in event cognitive processes using think aloud protocol in golf. Frontiers in Psychology, 6, 1–12. 3

 Whitehead, A. E., Taylor., J. A., & Polman, R. C. J. (2016). Evidence for skill level differences in the thought processes of golfers during high and low pressure situations. Frontiers in Psychology, 6, 1-12