How Therapy Can Support Elite-Level High School, Collegiate, and Professional Athletes

The Summer Olympics in Paris just ended, and aside from the grief of needing to find something else to do with my time outside of marveling at any and all sport, I’m left to reflect on the triumphs and challenges of athletic performance. Throughout the games, mental health needs and practices were on constant display. How amazing it was to hear Simone Biles talk about her pre-performance therapy sessions or watch Steve Nedoroscik meditate on the side waiting and waiting for his time to shine. The Olympic website even did a feature on mental health here: https://olympics.com/en/news/world-mental-health-day-2023-olympians-advice

As a therapist, I was ecstatic to see not only the acceptance and acknowledgement that mental health needs are real, but also the free discussions of mental practice and therapy acknowledged by the athletes, their coaches, and the commentators.

As a therapist who works with tons of “high performers,” I love to talk about the mind-body connection. It is always there, and athletic performances bring that connection to the front of the stage. I also love to talk about what therapy is (and isn't) for athletes and performance. Therapy isn't just about performance—it’s about supporting athletes holistically, both in and out of their sports. As a therapist who works with athletes, it is important to make this clear to my clients. Therapy in my office isn’t about what the goals are for your team/college/country, it's about your goals and needs.

The Pressures of Being an Elite Athlete

I often hear from athletes that people love to comment on how much they “practice.” So much assumption of time in “practice.” Rarely is there acknowledgement of the other commitments elite athletes make–nutrition, physical therapy, sleep, strength training, and (hopefully) mental conditioning and mind/body practices. Not to mention studying, school work, work if an adult, marketing if needed, and family/friend/romantic commitments.  All of this in the atmosphere of needing to excel, be the best, and not let anyone else down AND WIN. 

I like to say that everyone only gets 24 hours in a day, and certainly the list above makes it a jam packed one. Burnout is real and prolific. Physical injury and overuse is constant. And, as Simone Biles coined in interviews, “mental injury” is as copious and invisible. 

Athletes are uniquely vulnerable to “mental injury” and mental health issues. Recent research has shown that athletes are more at risk for mental health diagnoses than the general population. In fact, 2024 research shows that suicide is the second most common cause of death among NCAA athletes, only surpassed by accidents. https://bjsm.bmj.com/content/early/2024/03/05/bjsports-2023-107509

There is no doubt mental health care for athletes at all levels is a public health concern. So what can therapy do for an athlete?

Therapy isn’t just about mental strategies for winning—it’s about emotional resilience, self-care, and finding balance. It is often most impactful when focusing on helping an athlete build emotional flexibility and mental resilience alongside delving into individual values, goals and needs. It’s also a safe space. A place where an athlete can be themselves without fear of repercussion. In the highly competitive world of sport, this can have enormous positive impact. 

Navigating Life Outside of Sport:

Therapy is often there when others have moved on.

A particularly vulnerable time for athletes approaches when they become “former” athletes. Sometimes they plan this transition, but often it is made for them. Injuries end careers, rosters get cut, and athletes are left to pick up the pieces. THerapy is a wonderful tool for support through major life changes: college transitions, retirement from sports, moving to different cities/countries, etc. Part of my joy when working with athletes is when I can help them determine their identity outside the game. 

But Lisa, isn’t Therapy for Performance Enhancement?

In short, no. Will building a tool kit for mental wellbeing help you in sport? Maybe. But will it help you become a more resilient person regardless of the spot on a team? Most likely. 

Therapy is not only for improving performance or getting back in the game, it’s for personal growth, mental wellness, and emotional clarity.

Therapy supports athletes in more ways than just in sport—it helps them build balanced, fulfilling lives. I love being a champion for athletes at any phase of their career. Consider therapy as a tool for personal well-being, not just for athletic success. If this resonated with you, reach out to a therapist and add them to your or your child’s support team today. 

Lisa Schneider, LCSW is a psychotherapist in NY, CT, PA and CO and can be reached at www.acalmplace.net lisaschneiderlcsw@gmail.com

This blog is not intended as medical advice or diagnosis and should in no way replace consultation with a medical professional.