Can Written Disclosure Reduce Psychological Distress and Increase Objectively Measured Injury Mobility of Student-Athletes? A Randomized Controlled Trial
Injured students-athletes took part in a randomized controlled trial to test whether written disclosure could reduce psychological distress and improve injury mobility. Writing took place alongside prescribed physical rehabilitation and consisted of three 20-minute writing sessions, once a week for three consecutive weeks. Participants in the experimental injury-writing group followed a structured form of written disclosure, called the guided disclosure protocol (GDP). They firstly, wrote about the onset of their injury in a chronological manner, secondly, they explicitly labelled their emotions and described the impact of the injury, finally they wrote about future coping and psychological growth. Controls wrote about nonemotional and noninjury related topics. In addition to self-report measures, a physiotherapist, blind to experimental condition, assessed mobility at the injury site. Although self-report indices remained unchanged, the GDP group evidenced a significant improvement in injury mobility compared to controls. 1. Introduction Empirical work with athletes reveals that sports injury can cause considerable psychological distress [1–3] and that injured athletes have higher levels of emotional disturbance than noninjured controls [4]. The consequent withdrawal from training and competition can also be destabilizing [5]. Moreover, loss of athletic identity, withdrawal from the social climate of sport, and the possibility that an injury is career ending create an atmosphere of extreme anxiety and isolation which researchers and practitioners liken to a grief process [6–8]. There is also evidence that the emotional milieu of injury impacts upon an athletes’ perceived and actual rehabilitation [9]. Moreover, models of injury coping and prevention suggest that poor psychological recovery may leave athletes more susceptible to reinjury [5, 10]. It is thus widely acknowledged that processing cognitive and emotional distress and helping athletes cope with sport-specific situational factors following injury are essential for adherence to treatment and eventual recovery [5, 11, 12]. Awareness of such factors has led to an increase in psychological interventions being implemented alongside standard physical rehabilitation protocols. Although, Reese and colleagues applauded such integrated practice they nevertheless queried the efficacy of psychological interventions in sports injury rehabilitation [13]. In a recent review they found that interventions consisting of guided imagery, relaxation, microcounselling skills, acceptance and commitment therapy, and
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