Integrating Performance Psychology into Clinical Practice

As clinicians, we often have the goal of diversifying our clinical practice. And we know that you don’t necessarily have to experience the same life events to help others through their personal journey—for instance, I can help parents in my practice even though I’m childless. The same is true when working with athletes or other high performers. 

The term “high performer” is used in the practice of performance psychology—which can also be referred to as sport psychology—and providers don’t have to have been a high performing athlete to help others in their own performance. 

The Anxiety of High Performance

I was raised in an athletic home—both of my older brothers played at various levels of professional baseball. Being the youngest of three high-performing boys was challenging for me. I felt like I was trying to follow in their footsteps—but I was never as interested in or as good at baseball as my brothers were. 

In high school I started swimming in the year-round program, and it turned out I was pretty good at it. Every year I competed in elite championships like the  Olympic Trials, Nationals, US Open, and NCAAs. These high-stakes circumstances were opportunities for me to feel anxiety and question my abilities when competing against some of the most talented athletes in the world. After completing my graduating training in counseling psychology, I learned about the practice of sport and performance psychology.

How CBT Relates to Performance Psychology 

As part of my graduate studies, I learned about cognitive and behavioral therapy (CBT), which is often utilized when working with high performers. High performers like goals and measurable outcomes (think SMART goals), which is why CBT worksheets can fit nicely into the practice of performance psychology. Principles such as cognitive distortions, behavioral modification and rehearsal are often used with this population. 

Consider a chief financial officer (CFO) who has to present findings to their company, but dislikes public speaking. CBT principles can be used to help them overcome their discomfort. They might benefit from understanding the role their thought distortions play in the delivery of their speech, that their bodily sensations are just symptoms and not actually dangerous, and that rehearsing the speech before in sessions can help ease the delivery. 

While this CFO could also be referred to a media or other executive-level coach, it’s important for providers in the performance psychology space to know how they can provide support for high-performing executives like this to succeed. 

So What is Performance Psychology? 

Performance psychology is the practice of assisting athletes or other high performers overcome obstacles that impede their ability to reach their optimal level of functioning. While it could be specific to a race, meet, or game—or a speech performance like the CFO has to give—it could also be about the more general aspects of life. Values-directed living, family or romantic challenges, a period of career transition, and many other parts of daily life can be obstacles to people reaching their full potential. 

The interventions for high performers are often fundamentally rooted in some evidence-based treatment such as CBT, although that’s not necessarily a prerequisite. Just as with any clinical practice, much of the work boils down to the client-clinician relationship. I’ve found that my ability to connect with and empower individuals to align with their true selves, or perhaps find their genuine selves, yields productive outcomes. 

Focus on Progress, Not the Outcome

Although I just wrote “outcome,” providers working within performance psychology can’t guarantee wins or losses. Rather, we emphasize the importance of working through the process. No one, no provider or other professional, can make a guarantee when it comes to outcome. I can hypothesize that people will be less stressed, in greater contact with the present moment, and build a healthier relationship with the barriers affecting their performance or other functioning. But, I can’t make guarantees related to the outcome.

If you’re a sports fan, think about a high-performing NBA player shooting free throws. They can make 100 in a row in practice without one miss. In the first quarter they’ll often do the same—so why do some miss these same shots down by one point with 30 seconds left in the game?

It’s more about how they approach the shot—their process. It has nothing to do with their mechanics, or the outcome of missing or making the shot. It’s almost entirely based on their perception of who’s watching, the importance of the shot and the subsequent pressure, and their own internal dialogue. 

Providers working within performance psychology can help clients break down the process of these shots. Together, client and clinician can work on building a relationship with the internal dialogue and one’s confidence, so they get closer to their optimal performance.