NEDA TOOLKIT for Coaches and Trainers
Psychologists’ stories
How to work effectively with your athlete’s treatment team
Talking with Carlin M. Anderson, PhD
Carlin M. Anderson, PhD, is a sport psychologist at the
University of Minnesota who works frequently with
eating-disordered athletes, their coaches and families.
For coaches used to being the primary guiding force in
athletes’ lives while they are engaged in their sport, the
sudden intrusion of other professionals into the picture
can be off-putting and a difficult adjustment. This is
the frequent scenario the coach or athletic trainer
encounters when an athlete is diagnosed with an eating
disorder: the athlete’s meal plan, training, playing
schedule and priorities are often altered dramatically,
upsetting the natural coach-athlete relationship.
Having an athlete in treatment for an eating disorder
can be both a relief and a challenge for a coach. It
can be a relief that your athlete is getting help, but
also difficult to know how to work with your athlete’s
treatment team. Trust issues between coaches and
eating disorder specialists are more common than
many people realize. When I work with coaches, one
of the first things I talk about is where they fit in and
the role they can play in their athlete’s recovery. It’s
hard when the coach feels left out of the process
and/or unsure of how treatment might affect the
athlete’s performance. An athlete in recovery from
an eating disorder needs both a treatment team and
a management team. A treatment team is composed
of health care professionals, and it might include a
therapist, dietitian, physical therapist, family members
and medical doctor. A management team includes the
coach, athletic trainer and family, who help manage
and carry out the plan of the treatment team. Although
many medical doctors and therapists do not include
coaches in management of the athlete, if you are able
to establish a rapport with the treatment team, you
can play an important role in the management of your
athlete’s recovery.
Athletes will have different degrees of comfort in
sharing information with their management teams.
Most athletes are willing to share treatment progress,
such as “I’m meeting with my therapist twice a week,
and things are going okay,” but they are usually less
comfortable sharing personal details, such as body
image concerns, feeling unmotivated at school, or
dealing with depression. I try to encourage athletes to
clarify what they feel comfortable sharing with their
coach in a release of information form, so that the
coach can be kept up to date on the athlete’s progress
without the athlete feeling as though his or her
confidentiality is being jeopardized. For example, if your
athlete is not showing up for a therapist’s or doctor’s
appointment, the coach is informed. The coach can talk
to the athlete about the missed appointment, just as
one might when an athlete misses an appointment with
an academic tutor.
It can be extremely hard for coaches to make training
decisions for an athlete with an eating disorder when
they are not privy to the decisions of the treatment
team, and I sometimes see coaches who feel frustrated
and shut out. You might feel that treatment providers
have forgotten about your important role in the
athlete’s life, or that they think you won’t understand
the medical issues. Often legal confidentiality issues
prevent you as coaches from having the degree of
access you would like. However, if you are aware of the
legal constraints from the beginning, it is possible to
forge a good relationship with the treatment team.
The best approach is to be proactive in your efforts to
work with your athlete’s treatment team. Good rapport
with the treatment team will make it easier to get the
information you need. Voice an interest in his or her
treatment plan. Find out more about the professionals
on your athlete’s treatment team. Ideally, a member of
the treatment team will talk to the athlete’s coach to
learn more about the sport and its demands, and will
speak with the athletic trainer about how the athlete
should be training. If you are a trainer, you may feel you
need more information in order to tailor practices for
your athlete. Ask questions. Should you have him or her
run as hard as everyone else? To what degree can you
push your player and what can you expect from this
person in a game or meet? The treatment team may
inform you that your athlete is in danger and needs to
stop participating in their sport for a while. You may
feel that the athlete is performing better than ever.
There are situations where, yes, an eating disordered
athlete’s performance improves in the short run, but
the behaviors the athlete is engaged in will eventually
result in impaired performance and potentially serious
physiological problems. Pulling an athlete from a
team is a difficult decision. I have never worked with
a treatment team that takes this decision lightly. If
your athlete is young and still growing, the team may
be more cautious in allowing continued participation,
whereas with a collegiate athlete on scholarship,
the team may want to keep him or her in as long as
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