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Cognition and perception, Emotion, Social and behavioural, Sport and Exercise

Smarter thinking in sport

Martin James Turner describes his use of rational emotive behaviour therapy (REBT) with athletes

28 August 2014

Some people believe football is a matter of life and death. I am very disappointed with that attitude. I can assure you it is much, much more important than that
Bill Shankly, Manager of Liverpool Football Club, 1959–1974 

We are all irrational. In situations that matter most to us, this irrationality rears its ugly head and we find ourselves rigidly demanding that we must get that promotion, absolutely have to pass that driving test, because failure would be terrible, awful, the end of the world! In reality, we really want that promotion, would very much like to pass that driving test, because failure would be bad, inconvenient, but certainly not the end of the world!

Now consider the sporting context. While Bill Shankly may have had his tongue firmly in his cheek, the quote that starts this article is a perfect reflection of what many people think about sporting competition. It seems like every other day the media reports 'must win' sporting contests, 'do or die' performances, and 'devastating' competitive losses. In a recent article (Bernstein, 2013) the ex-England football manager Sven-Goran Eriksson talks about the psychology of penalty taking. 'It's not easy to take a penalty when you have the nation relying on you. It is life or death,' he says. If players approach penalties with this extreme attitude, it is little wonder that of the 'major nations' England have the worst penalty shoot-out record in the world (17 per cent success rate; see tinyurl.com/lkzdk24 for details). In another article, the Brazilian goalkeeper Julio Cesar talks about why he thinks the Brazil national football team have experienced a dip in form of late (Bowater, 2013). 'In Brazil, we always have to win, everybody knows that. It's too much pressure,' he comments.

Of course winning for an athlete is important and a tough opponent will make that success difficult to achieve. But the addition of irrational beliefs such as rigid and inflexible demands may render the athlete simply too anxious to fulfil their potential. The challenge for psychologists working in sport is to help athletes to avoid adopting irrational, illogical and unpragmatic beliefs, and promote rational, logical and pragmatic alternatives, an endeavour that forms the principal goalsof REBT.

I will briefly detail the fundamental aspects of REBT, but specifically, I will justify the use of REBT in sport, and disclose how I use REBT as a part of my consultancy work with athletes.

Why is REBT useful in sport? 

The use of REBT in sport is growing steadily. Sport is beginning to embrace REBT more because the athletic context is rife with irrational philosophies, cultured by 'win at all costs' mantras in an ego-driven climate perpetuated by coaches, parents and athletes themselves (Harwood, 2008). A climate promoting the notion that winning is all that matters, coupled with the irrational beliefs prevalent in athletes (Cockerill, 2002), is likely to render many athletes unable to cope with the host of adverse situations they will experience over the course of their careers. For example, athletes are required to deal with competitive pressure, long- and shortterm injury, unexpected setbacks, rejection by coaches, unfair treatment by others, and of course failure when it matters most.

The notion that REBT can deliver coping possibilities, helping athletes to deal with these adversities, stems from its fundamental aims. In short, REBT aims to help individuals abandon their irrational beliefs in favour of rational beliefs, their unhelpful emotional and behavioural reactions to adversity to helpful ones. REBT can offer huge potential gains to athletes by helping them to control their reactions to tough and often uncontrollable circumstances. But one potential barrier to using REBT in sport is that it is still considered very much a clinical 'psychotherapy' type of approach, which can be off-putting to coaches, athletes, and indeed sport psychologists (e.g. Marlow, 2009). So next I will explain what REBT is.

What is REBT? 

REBT was conceived as the first cognitive behavioural approach to counselling by Albert Ellis in 1955 (then called rational therapy). Ellis proposed that it is rarely the adversity (failure, rejection and ill treatment) that causes dysfunctional emotions (e.g. unhealthy anger, anxiety, depression) and maladaptive behaviours (e.g. avoidance, violence, withdrawal) alone, rather it is the beliefs about adversity that cause these unhealthy responses (Ellis, 1957). REBT is distinguished from other cognitive behavioural therapies by maintaining the fundamental premise that irrational beliefs lead to unhealthy emotions and maladaptive behaviours, while rational beliefs lead to healthy emotions and adaptive behaviours. In REBT 'unhealthy emotions' refers to emotions that are associated with pain and discomfort, lead to self-defeating behaviour, and impede the client from taking necessary actions to achieve their goals. The term 'healthy emotions' refers to emotions that do not immobilise the client, but motivate them to take a constructive view of the situation, and to take action designed to help achieve their goals (Ellis et al., 1997). Specifically, there are four types of irrational belief, one primary (demands) and three secondary (awfulising, low frustration tolerance, self-depreciation); the secondary beliefs are derived from the primary belief. In parallel, there are also four types of rational belief, one primary (preferences) and three secondary (anti-awfulising, high frustration tolerance, self-acceptance); again the secondary beliefs are derived from the primary belief (Dryden, 2012).

Irrational beliefs lead to dysfunctional emotions (e.g. unhealthy anger) and maladaptive behaviours (e.g. violence), and rational beliefs lead to functional emotions (e.g. healthy anger) and adaptive behaviours (e.g. assertiveness). In non-sport settings, irrational beliefs have consistently been associated with emotional dysfunction (Banks & Zionts, 2009; MacInnes, 2004), such as heightened anxiety, feelings of anger and shame, and psychopathological conditions including depression, anxiety (trait, social, speech, test, evaluation), and suicide thoughts (for review see Browne et al., 2010). In addition, irrational beliefs have been associated with maladaptive behaviours, such as social avoidance, self-harming, procrastination, anger suppression, aggression, violence and medication use (for review see Szentagotai & Jones, 2010).

In short, irrational beliefs lead to emotional and behavioural reactions that are dysfunctional, maladaptive and therefore inhibit goal achievement. For example, in the face of pressured performance situations irrational beliefs may lead to an individual withdrawing mentally and physically (Dryden & Branch, 2008). In most athletic circumstances this is likely to inhibit peak performance. In contrast, rational beliefs may lead to the individual facing up to the situation and taking constructive action to minimise danger (Dryden & Branch, 2008), which is more likely to facilitate performance. Therefore, the reduction of irrational beliefs and the promotion of rational beliefs, thus changing the way in which an event is cognitively appraised (David et al., 2002; Hyland & Boduszek, 2012), can be beneficial for the well-being and performance of athletes.

To illustrate, an athlete's primary irrational belief 'I want to succeed and therefore I must' may cause unhealthy anxiety prior to crucial competition. REBT would encourage the athlete to abandon this irrational demand and replace it with a rational preference such as 'I really want to succeed but that doesn't mean I must' leading to concern (healthy anxiety) instead. In short, irrational beliefs cause the unhealthy anxiety, not the situation (e.g. important competition) alone (Harris et al., 2006).

REBT's theory and efficacy have been supported in both clinical and non-clinical populations with youths and adults (David et al., 2005; Gonzalez et al., 2004). Indeed, three meta-analyses concerning the use of REBT on psychological disturbance report effect sizes of 0.95 (Lyons & Woods, 1991), 1.62 (Engles et al., 1993), and 0.50 (Gonzalez et al., 2004). In particular, one meta-analysis concluded that REBT's superiority over other treatments was directly related to increases in rational thinking, confirming REBT's central premise (Engles et al., 1993). In sum, REBT is an effective treatment for dealing with a host of dysfunctional emotions and maladaptive behaviours.  

Using REBT in sport 

Most commonly when I use REBT with athletes I introduce them to an ABCDE framework and encourage them to understand that activating events (A) alone do not cause unhealthy emotional and behavioural consequences (C). It is irrational beliefs (B) about the adversity that are often the real cause (Ellis & Dryden, 1997). That is, for an athlete it is not being deselected or rejected by the coach (A) that causes unhealthy anger alone, it is usually the irrational belief that the coach 'must be fair to me, and I cannot stand being treated unfairly' (B) that leads to the dysfunctional emotional consequence (C). The athletes then learn to dispute (D) their irrational beliefs and are encouraged to form new effective rational alternatives (E). Disputation helps the athletes to understand that their irrational beliefs are false, illogical and unhelpful, and that rational alternatives are true, logical and helpful (Dryden & Branch, 2008). In my work, athletes are typically introduced and guided through the ABCDE framework via one-to-one consultations, or using group educational methods.

To assist me in my use of REBT with athletes, I have adopted a six-step approach (see Figure 1). The first step is about helping the individual to recognise their irrational beliefs, and this includes a significant amount of education and discussion concerning the ABC elements of REBT. The next three steps are encapsulated by the disputing (D) stage of the REBT process and involve helping the individual to challenge their irrational beliefs. Steps 5 and 6 are encapsulated by the effective rational beliefs (E) stage of the REBT process, and involve encouraging the individual to adopt preferential, anti-awfulising, high frustration tolerance, and acceptance beliefs. Step 6 typically involves developing tools that the individual can use to ensure that their new rational beliefs stand the test of time. For example, they might produce rational self-statements on cue cards designed to reinforce their new beliefs, which are placed where the individual will see them frequently (e.g. fridge door, bag, bedside table). Inbetween each session, homework is set in collaboration with the individual, which may include cognitive assignments (ABCDE self-help worksheets), emotional assignments (rational emotive imagery), or behavioural assignments (deliberate exposure to adversity).  

My experiences of using REBT in sport are very positive (see Turner & Barker, 2014, for more): using one-to-one sessions alongside group education workshops, I tend to find that in nine to ten sessions athletes are able to use the REBT model to effectively reduce their irrational beliefs in favour of rational beliefs. To my surprise, coaches and sport directors have been very supportive of my use of REBT. To assuage clinical connotations I will often describe REBT as 'Smarter Thinking' to coaches and managers, thus removing a potential barrier to the use of REBT. Anecdotally, they like the structured nature of REBT, and can relate to the logical and pragmatic philosophies it promotes. This is important because significant others that spend more time with the athletes than psychologists have an opportunity to reinforce the ideals of REBT at appropriate moments. For example, one coach adopted the question 'What are you saying to yourself about this match?' when he felt that one of his athletes was struggling with nerves prior to a competition. This would then trigger the athlete to locate the irrational belief and dispute it in order to regulate his or her emotions. Certainly, closer work with coaches would benefit the development of REBT in sport settings.

Research in sport 

To be blunt, there is a dearth of literature exploring the use of REBT in sport. To my knowledge, there have been approximately a dozen published articles concerning REBT in sport (for prime examples see Bernard, 1985; Elko & Ostrow, 1991; Marlow, 2009). To address the scarcity in research, I have led a programme of research along with my colleagues at Staffordshire University to investigate the theoretical and therapeutic efficacy of REBT in sport contexts.

Initially, we wanted to see if REBT would help youth cricketers reduce their anxiety using one-to-one REBT sessions (Turner & Barker, 2013). We took four athletes through a three-session REBT programme tailored to their specific issues and irrational beliefs. Athletes also completed weekly homework assignments. We tracked their progress over time from pre-REBT baseline, through the intervention phase, and for a number of weeks after the intervention had finished. We applied a single-case design where each athlete commenced REBT at differing points. That is, we staggered the intervention delivery. This is known as a multiple-baseline across participants design (Barker et al., 2011), and it allowed us to see if irrational beliefs and anxiety changed at intervention onset for each athlete. On inspection of the data we saw that irrational beliefs and cognitive anxiety reduced at the point at which REBT was applied, and remained reduced over a four- to eight-week period.

Our research and consulting experiences indicate that REBT is effective in reducing the irrational beliefs and anxiety of athletes on a one-to-one basis, but as sport psychology consultants, we are not often afforded the luxury of consistent one-to-one time with athletes. Indeed, a lot of my work is done via group workshops in which athletes are educated in psychological skills. I personally feel that I am more effective in one-to-one settings, and in my recent work with the England futsal team I am lucky that it is possible to fully engage the athletes in psychological skills training. We can then decide together whether REBT is appropriate, and if so, to spend considerable time helping the athlete to imbed the principles into his psychological approach to performance. Nonetheless workshops are important as they give me an opportunity to deliver a consistent message to multiple athletes. Because of the time and cost effectiveness of workshops, we wanted to see if REBT education was effective in reducing the irrational beliefs of athletes.

In the first study (Turner et al., 2014) we used a single REBT workshop in which professional academy soccer athletes were introduced to the ABCDE aspects of REBT and completed various tasks and activities helping them to understand the key aspects of how to apply it. This brief workshop had only an immediate impact on irrational beliefs as athletes reported a reduction from baseline levels straight after the session, but then a return to baseline two months after the workshop. In essence, this single workshop was effective in raising awareness of irrational beliefs, reflected in reduced self-reported irrational beliefs, but was predictably insufficient in causing long-term change. So next we applied three REBT workshops with professional academy soccer athletes, allowing more time to help athletes understand REBT and to practise how they would use the principles in training and competition (Turner et al., in press). We again monitored irrational beliefs over time, and also monitored a control group with the same measures. We saw that from baseline levels irrational beliefs reduced straight after the workshop and remained reduced for two months after the workshops. The control group experienced no reductions in irrational beliefs.

Obviously, the most effective model of practice would be to use workshops and one-to-one sessions with athletes to maximise the effects of REBT. This is certainly an area for future research, one of many possible investigations that would help to develop a more detailed understanding of how we can use REBT in sport contexts. Others would include determining the prevalence of irrational beliefs in athletes; this is a priority because although anecdotally we know irrational beliefs are particularly prevalent, there is no formal quantitative or qualitative evidence for this in the literature. In addition, the precise effect REBT may have on actual athletic performance is yet to be fully determined. In our research, athletes report perceived performance benefits, and the sparse research in sport reports some positive effects, but meaningful performance measurement needs to be carried out to understand the true effects of REBT. Lastly, good-quality, well-controlled experimental studies comparing REBT to other forms of psychological skills training would help to elucidate what REBT offers over and above more traditionally used and invaluable methods in sport (e.g. the canon of psychological skills: Andersen, 2009).

Conclusion 

Of course, alongside irrationality there are some great examples of rationality in sport. For example, the current England manager Roy Hodgson quite rationally said: '…after 36 years the words "must win" leave me rather cold. Most teams go on the field wanting to win. I don't know how you achieve a "must win" other than going out to try and play' (Lawton, 2012). Boris Becker famously commented 'I didn't start a war. Nobody died. I only lost a tennis match, nothing more' after losing in the second round of the 1987 Wimbledon Championships. At the 2013 championships Rafa Nadal (12-time Grand Slam tennis champion at that point) crashed out of the first round (for the first time in his career) losing to Steve Darcis, a 100-1 outsider ranked 135 in the world, in just 1 hour 8 minutes. Nadal's response to losing this match? 'It's tough losing in the first round but life continues… It's not a tragedy, it's sport.'

Rafa Nadal's 'not a tragedy' response is one of anti-awfulising, a rational and logical reaction to an adverse event. Nadal went on to win the 2013 US Open to bring his Grand Slam tally up to 13. From the evidence I have presented in this article, clearly more rational, logical and pragmatic beliefs and philosophies are important for sport performance, mental health, and psychological well-being, and to this end, REBT is a well-supported approach that can help athletes to fulfil their potential.

I hope that this article will encourage more psychology practitioners to use REBT in their work with athletes, and crucially to formally report their endeavours.

- Martin Turner is a lecturer in sport and exercise psychology at  Staffordshire University 
[email protected]

References

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