Routledge Handbook of Athlete Welfare 0367193256, 9780367193256

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Routledge Handbook of Athlete Welfare

Athlete welfare should be of central importance in all sport. This comprehensive volume features cutting-­edge research from around the world on issues that can compromise the welfare of athletes at all levels of sport and on the approaches taken by sports organisations to prevent and manage these. In recent years, sports organisations have increased their efforts to ensure athlete health, safety, and well-­being, often prompted by high-­profile disclosures of sexual, physical, and emotional abuse; bullying; discrimination; disordered eating; addiction; and mental health issues. In this book, contributors lift the lid on these and other issues that jeopardise the physical, emotional, psychological, social, and spiritual welfare of athletes of all ages to raise awareness of the broad range of challenges athletes face. Chapters also highlight approaches to athlete welfare and initiatives taken by national and international sport organisations to provide a safer, more ethical sports environment. As the first book to focus exclusively on athlete welfare, this is an essential read for students and researchers in sports studies, coaching, psychology, performance, development and management, and physical education. It is also a useful reference point for anyone working in welfare, safeguarding, child protection, and equity and inclusion in and beyond sport. Melanie Lang is Assistant Director of the Centre for Child Protection and Safeguarding in Sport and a senior lecturer in child protection in sport at Edge Hill University, UK. She is co-­editor of the book Safeguarding, Child Protection and Abuse in Sport: International Perspectives in Research, Policy and Practice (Routledge, 2015).

Routledge Handbook of Athlete Welfare

Edited by Melanie Lang

First published 2021 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 52 Vanderbilt Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2021 selection and editorial matter, Melanie Lang; individual chapters, the contributors The right of Melanie Lang to be identified as the author of the editorial material, and of the authors for their individual chapters, has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing-­in-­Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-­in-­Publication Data Names: Lang, Melanie, editor. Title: Routledge handbook of athlete welfare / edited by Melanie Lang. Other titles: Handbook of athlete welfare Description: Abingdon, Oxon ; New York, NY : Routledge, 2021. | Series: Routledge international handbooks | Includes bibliographical references and index. Identifiers: LCCN 2020021197 | ISBN 9780367193256 (hardback) | ISBN 9780429201745 (ebook) Subjects: LCSH: Sports—Psychological aspects. | Sports—Safety measures. | Athletes—Mental health. | Athletes—Health and hygiene. | Athletes—Training of—Moral and ethical aspects. | Sports injuries—Moral and ethical aspects. | Sports for children—Moral and ethical aspects. | Coaching (Athletics)—Moral and ethical aspects. Classification: LCC GV706.4 .R684 2021 | DDC 796.01—dc23 LC record available at https://lccn.loc.gov/2020021197 ISBN: 978-­0-­367-­19325-­6 (hbk) ISBN: 978-­0-­429-­20174-­5 (ebk) Typeset in Bembo by Apex CoVantage, LLC

For my family, with all my love.

Contents

List of contributors xi Acknowledgementsxviii Introduction Melanie Lang

1

PART I

Conceptualisations of athlete welfare

13

  1 Developments in international policy on athlete welfare Melanie Lang

15

  2 Scientism and the welfare of athletes: minds, brains, genes and agency Leon Culbertson

24

  3 Organisational obligations toward athlete transitions: confronting the bureaucratisation of athlete welfare with an ethics of care G. Z. Kohe and L. G. Purdy

33

  4 Athlete shaming and the ethics of care: opposing forces in sport coaching Emily McCullogh and Parissa Safai

43

PART II

Current concerns in the welfare of athletes

55

  5 Gendered violence in women’s artistic gymnastics: a sociological analysis57 Natalie Barker-­Ruchti, Astrid Schubring and Carly Stewart

vii

Contents

  6 Psychological abuse in competitive and high-­performance women’s volleyball Alixandra Krahn   7 Presenteeism in elite sport organisations: a framework for understanding athletes’ decisions to practise sport despite health concerns Jochen Mayer, Felix Kühnle and Ansgar Thiel

69

81

  8 The issue of athlete welfare and why tackling should be removed from physical education and school sport: #BanTackling94 Adam J. White   9 Welfare and the protection of young athletes: an analysis of the nature and prevalence of bullying behaviours in sport settings Miguel Nery, Carlos Neto, António Rosado and Peter K. Smith

105

10 Degrading and harming new teammates during hazing: ‘athletes will be athletes’ Jennifer J. Waldron

119

11 Exploring the links between self-­directed violence and child maltreatment and bullying in sport Sylvie Parent, Judith Kotiuga, Tine Vertommen and Kristine Fortier

128

PART III

Athlete mental health

139

12 Mental health in sport Brad Donohue and Davy Phrathep

141

13 Suicide among athletes Ashwin L. Rao

153

14 The athlete and addiction Carwyn Jones

163

15 Eating disorders and disordered eating in sport: the hidden role of sporting organisations and how the cycle can be broken Jenny McMahon

viii

173

Contents

PART IV

Equity and inclusion as an athlete welfare concern

181

16 The welfare of disabled people in sport Hayley Fitzgerald

183

17 Racial and ethnic diversity and racist ruptures in US youth soccer Alex Manning

196

18 Locked out: examining binary-­gendered locker rooms as a key site for trans athlete welfare Ali Greey

206

PART V

New agendas and missing voices

219

19 Virtual technologies as tools of maltreatment: safeguarding in digital spaces Emma Kavanagh, Chelsea Litchfield and Jaquelyn Osborne

221

20 The welfare of adolescent high-­performance action sport athletes: the case of young commercially sponsored Dutch kite surfers Froukje Smits

231

21 Examinations of sports workers’ welfare in spaces of geopolitical conflict: ‘The country is under threat, but the game goes on’ L. G. Purdy, G. Z. Kohe and R. Paulauskas

242

22 Pasifika rugby migration and athlete welfare: stairway to heaven David Lakisa, Jack Sugden and Brent McDonald 23 Countering the trajectories towards new forms of violence in youth: enhancing protective factors through sports Dean M. Ravizza 24 Sexual abuse ‘survivor’ research in sport Colin Harris and Mike Hartill 25 Factors influencing the mental health of sports match officials: the potential impact of abuse and a destabilised support system from a global context Tom Webb and Paul Gorczynski

251

263 277

289

ix

Contents

PART VI

Stakeholders in athlete welfare

301

26 The role of parents in promoting the welfare of children involved in sport Camilla J. Knight, Olivier Y. Rouquette and Maita G. Furusa

303

27 Consent and complicity: the athletes’ role in the normalisation of damaging coaching practices Chris Zehntner

314

28 Athlete welfare in coach–athlete romantic relationships Susanne Johansson 29 Moving beyond unproblematic policy implementation: some micro-­level reflections on social interaction, emotion, and the enactment of safeguarding policy in sport Andrea Scott-­Bell, Karl Wharton and Paul Potrac

324

336

PART VII

Approaches to prevention 30 Protection of the athlete: activities of the International Olympic Committee Margo Mountjoy, Kirsty Burrows and Susan Greinig 31 Criminal record checks as a tool to prevent child abuse in sport Melanie Lang and Maria Papaefstathiou

349 351 365

32 Protecting athletes against sexual violence: a club-­based approach from Germany Bettina Rulofs

376

33 Measuring the prevalence of interpersonal violence against children in sport Tine Vertommen and Sylvie Parent

385

34 Advancing autonomy-­supportive coaching through the application of the transtheoretical model Joseph Gurgis, Gretchen Kerr and Ashley Stirling

396

Index408

x

Contributors

Natalie Barker-­Ruchti is Associate Professor at the Division of Sport Science, School of Health

Sciences, Örebro University, Sweden, and the Founder of the International Socio-­Cultural Women’s Artistic Gymnastics (ISCWAG) research group. Kirsty Burrows is the Lead Consultant to the International Olympic Committee (IOC) on Athlete Safeguarding and Managing Director of Sports Rights Solutions. She is the author of the IOC Athlete Safeguarding Toolkit, and at Games-­time, she assumes the role of IOC Deputy Safeguarding Officer as part of the IOC Games Group. Leon Culbertson is Reader in Philosophy at Edge Hill University, UK. His main interests are in

the philosophy of mind, language, and logic; the philosophy of psychology; and the philosophy of Ludwig Wittgenstein. Brad Donohue is Full Professor in the Psychology Department and Director of the Optimum

Performance Programme at the University of Nevada, Las Vegas, USA. His research concerns the development of mental health programming in athletes. Hayley Fitzgerald is a professor in disability and youth sport at Leeds Beckett University, UK, and a visiting professor at the University of Worcester, UK. Her key edited works include Disability and Youth Sport (Routledge, 2009) and Equity and Difference in Physical Education, Youth Sport and Health: A Narrative Approach (Routledge, 2012). Kristine Fortier is a PhD candidate in the Department of Physical Education at Laval University, Quebec, Canada. Her research interests are focused on violence experienced by young athletes in sport, more precisely on child maltreament in sport. Maita G. Furusa is a PhD student in sport science at Swansea University, UK. His current research explores the meaning children assign to different types of parental involvement in sport. Paul Gorczynski is a chartered psychologist with the British Psychological Society and a senior lecturer of sport and exercise psychology at the University of Portsmouth, UK. Most recently, Paul was an expert panel member for the International Olympic Committee Consensus Statement on mental health in elite athletes. Ali Greey is a doctoral student in the Department of Sociology at the University of Toronto,

Canada. Their research examines how trans and non-­binary adults and youth experience xi

Contributors

binary-­gendered facilities and the barriers that these spaces pose to trans inclusion in sport, physical activity, and public space. Susan Greinig has headed the IOC Prevention of Harassment and Abuse in Sport initiatives

since 2004. Her responsibilities in the Medical and Scientific Department of the International Olympic Committee focus on education to protect the health of the athlete. Joseph Gurgis is a PhD candidate in the Faculty of Kinesiology and Physical Education at

the University of Toronto, Canada. His expertise is in coaching and coaching education, with a particular focus on autonomy-­supportive and developmentally appropriate coaching practices. Colin Harris is a senior lecturer in the Business School at Brighton University. He is a member of the English Football Association (FA) Survivor Support and Safeguarding Advisory Group and the Sport England Advisory Panel. His current research looks at the life-­histories of men who, in their early years, were sexually abused at football clubs. Mike Hartill is a Reader in the Sociology of Sport at Edge Hill University’s Department of

Social Sciences. He has conducted research into child sexual exploitation in sport for the past 15 years and delivered undergraduate programmes on child welfare in sport since 2002. Susanne Johansson is based at the Swedish School of Sport and Health Sciences in Stockholm, Sweden, where she lectures on the coach education and sport management programmes. Carwyn Jones is a professor of sports ethics and former president of the International Association for the Philosophy of Sport. He is the author of Routledge’s (2016) Sport and Alcohol: An Ethical Perspective and is a registered psychotherapist working voluntarily in the field of addiction. Emma Kavanagh is a senior lecturer in sport psychology and coaching sciences within the Department of Sport and Event Management at Bournemouth University, UK. Emma’s research centres on critically examining abuse in virtual and face-­to-­face sporting environments, understanding the duty of care, and enhancing safeguarding in sporting spaces. Gretchen Kerr is a full professor in the Faculty of Kinesiology and Physical Education and Vice-­

Dean of the School of Graduate Studies at the University of Toronto, Canada. Her research focuses on the psychosocial health of young people in elite sport, athlete maltreatment, and the promotion of developmentally appropriate coaching practices. Geoffery Z. Kohe is a lecturer in sport management and policy at the University of Kent, UK.

His research has predominantly focused on the historical, political, and sociocultural dimensions of the Olympic movement and sport organisations. Judith Kotiuga is a PhD student in clinical psychology (R/I) at Laval University in Quebec,

Canada. Her clinical and research interests focus on psychological and interpersonal factors affecting adolescents’ psychosexual development. Felix Kühnle is a lecturer in the sociology of sport and health at the Institute of Sport Science

at the Georg August University Göttingen, Germany. His research focuses on the sociology of xii

Contributors

high-­performance sports, the sociology of mental health and illness, and sociological systems theory. Camilla J. Knight is an associate professor in sport science, specialising in sport psychology at

Swansea University, Wales, UK. She is also the Youth Sport lead for the Welsh Institute of Performance Science and a member of the Welsh Safeguarding in Sport strategy group. Camilla is co-­author of Parenting in Youth Sport: From Research to Practice (Routledge, 2014) and co-­editor of Sport Psychology for Young Athletes (Routledge, 2017). Alixandra Krahn is currently completing her PhD in kinesiology and health science at York

University, Canada. Her master’s thesis explored coaches’ perceptions of athletes’ experiences of verbal and mental abuse. David Lakisa is a PhD candidate at the University of Technology Sydney, Australia. He is currently researching ‘Managing Pasifika in the National Rugby League’ and has worked as the Pacific Islander Coaching and Development Officer for the New South Wales Rugby League. Melanie Lang is Assistant Director of the Centre for Safeguarding and Child Protection in

Sport and a senior lecturer in Child Protection in Sport at Edge Hill University, UK. She is co-­editor of Safeguarding, Child Protection and Abuse in Sport: International Perspectives in Research, Policy and Practice (Routledge, 2015). Chelsea Litchfield is a senior lecturer and Acting Head of School of the School of Exercise Science, Sport and Health at Charles Sturt University in Bathurst, Australia. Chelsea’s research focuses on gender, sexuality, and sport and media, predominately in an Australian context. Alex Manning is an assistant professor of sociology at Hamilton College in Clinton, New York, USA. His research explores the dynamic collisions among race, families, youth, sport, and culture. His scholarship and writing have featured in journals such as The Du Bois Review and The Sociology of Race and Ethnicity. Jochen Mayer is Professor at the Institute of Sport Science at the Georg August University Göttingen in Germany and holds a professorial chair for the sociology of sport and health. He is also the spokesperson of the Sport Sociology Section within the German Association of Sport Science. Emily McCullogh is a PhD candidate in the School of Kinesiology and Health Science in the

Faculty of Health at York University in Toronto, Canada. Her research examines conceptualisations of care and caring in competitive youth sport and the implications of these for athletes’ experiences as well as coach–athlete relations. Brent McDonald is a senior lecturer in the sociology of sport at Victoria University in Melbourne, Australia. His research interests include sport and migration and its intersection with ‘race’, gender, and identity. Jenny McMahon is an award-­winning researcher, teacher, and former elite athlete, having

won numerous international medals. Her research is focused on abuse in sport, athlete well-­ being, education interventions centring on abuse, and coach education. She has used leading xiii

Contributors

qualitative methodologies and evaluations into her research on abuse in sport, which has foregrounded athlete and coach first-­hand experiences. Margo Mountjoy is a professor and dean in medicine at McMaster University, Canada. In her clinical career, she is a team physician and a clinical consultant in sport medicine at the University of Guelph’s Health and Performance Centre. She is the lead author on the IOC Consensus Statements on Harassment and Abuse in Sport and is a member of the IOC Working Group on the Prevention of Harassment and Abuse in Sport. Miguel Nery is a clinical psychologist, psychodynamic psychotherapist, and professor of psy-

chology and a researcher at the Motor Behaviour Laboratory at the Faculty of Human Kinetics at Lisbon University, Portugal. His main research interests are human development, psychopathology, human aggression, play, and sport. Carlos Neto is a full professor at the Faculty of Human Kinetics (FMH) of Lisbon University. He is the Portuguese representative of the International Play Association and the coordinator of the masters programme in child development in the FMH. He is the founder of the Portuguese Association of Physical Education. Jaquelyn Osborne is a lecturer and discipline lead in the School of Exercise Science, Sport and Health at Charles Sturt University in Bathurst, Australia. Jaquelyn teaches psychosocial dimensions of sport and exercise, particularly in sport sociology, sport history, and philosophy. Dr Osborne’s research is predominantly in the area of gender and the sports media. Maria Papaefstathiou is a scientific collaborator at the European University Cyprus and a

physical education primary teacher. Her research focus is on athlete welfare, safeguarding, and child protection in sport, and she served as a consultant within the Gender Equality in Sport Committee of the Cyprus Sport Organisation. Sylvie Parent is Full Professor in the Department of Physical Education at Laval University, Quebec, Canada. Her research focuses on violence against children and teenagers in sport. Through her work with government departments and the sport community, she is also involved in public decision-­making in Quebec. Rūtenis Paulauskas works at the Lithuanian University of Educational Sciences and Lithuania Sports University, Lithuania. His central areas of teaching and research pertain to coaching high-­performance basketball players, teaching sport concepts and skills, and the physical fitness of youth and adolescents. Davy Phrathep is a clinical psychology PhD candidate at the University of Nevada, Las Vegas (UNLV), USA. He is a researcher in Professor Brad Donohue’s the Optimum Performance Programme Lab at UNLV, helping to develop mental health and sport performance programmes for athletes. Paul Potrac is a professor of sport coaching in the Department of Sport, Exercise and Reha-

bilitation at Northumbria University, UK. His teaching and research focus on the social and embodied nature of sports work, inclusive of the paradoxes, challenges, and complexities that sports workers encounter in their everyday practice. xiv

Contributors

Laura G. Purdy’s research focuses on the careers and lives of sports workers in elite/professional sport. Her recent projects have examined the welfare, representation, and advocacy of sport workers in European contexts. She works at Edge Hill University, UK. Ashwin L. Rao is an associate professor in the Department of Family Medicine at the University of Washington (UW), USA. He serves as the UW’s sports medicine fellowship director and as a team physician for the University of Washington’s Husky Athletics and the Seattle Seahawks. He is also an elected member of the Board of Directors of the American Medical Society for Sports Medicine. Dean M. Ravizza is a professor in the Department of Secondary and Physical Education and a senior research practitioner in the Bosserman Centre for Conflict Resolution at Salisbury University, Maryland, USA. He also serves as a programme facilitator/mediator for the US State Department’s Sports Diplomacy Division. In 2018, he was named a Rotary International Peace Fellow to enhance the role of sport in peacebuilding and conflict resolution. António Rosado is a full professor at the Faculty of Human Kinetics (FMH) of Lisbon Univer-

sity, Portugal. He is a member of the Sport and Exercise Psychology Laboratory. He is involved in a series of studies related to the development of models and methods in the fields of sport pedagogy and sport psychology. Olivier Y. Rouquette is a PhD student in sport sciences and psychology as part of a joint

research degree at Swansea University, UK, and the Université Grenoble-­Alpes, France. Olivier’s research is focused upon understanding and examining parent–athlete relationships in sport. Bettina Rulofs is Professor of Sports Sociology at the University of Wuppertal, Germany.

Before that, she was Senior Lecturer at the German Sport University in Cologne. Her research and teaching areas are social diversity and inequality in sport, gender and diversity studies in sport, and violence in sport, with a particular focus on the prevention of sexual violence. Parissa Safai is Associate Professor in the School of Kinesiology and Health Science in the Faculty of Health at York University in Toronto, Canada. Her research interests focus on the critical study of sport at the intersection of risk, health, and health care. This includes research on sports’ ‘culture of risk’, the development and social organisation of sport and exercise medicine, and the social determinants of athletes’ health. Astrid Schubring is Associate Professor at the Department of Food and Nutrition and Sport

Science at the University of Gothenburg, Sweden. Her research is sociological in nature and revolves around topics such as youth in sport, athlete health and well-­being, and career development. Andrea Scott-­Bell is a senior lecturer in the sociology of sport and sport development in the Department of Sport, Exercise and Rehabilitation at Northumbria University, UK. Andrea’s research interests are broadly focused on athlete welfare in sport, including understanding athlete and practitioner experiences and management of injury, illness and mental well-­being, and the enactment of welfare policy in practice. Peter K. Smith is Emeritus Professor of Psychology in the Unit for School and Family Studies at Goldsmiths College, University of London, UK. He is the author and editor of numerous xv

Contributors

books, including The Psychology of School Bullying (Routledge, 2019). In 2015, he was awarded the William Thierry Preyer Award for Excellence in Research on Human Development by the European Society for Developmental Psychology. Froukje Smits is a senior researcher with the Participation and Urban Development Research Group and a lecturer at the Institute of Social Work at the Utrecht University of Applied Sciences in the Netherlands. Her research and teaching focus on the social impact of sport and physical activity. Carly Stewart is Head of the Department for Sport and Event Management at Bournemouth

University, UK. She is a member of the International Socio-­Cultural Women’s Artistic Gymnastics research group (ISCWAG), convenor of the British Sociological Association’s Auto/ biography study group, and editor of Auto/biography Review. Ashley Stirling is currently an associate professor, Teaching Stream, and the Vice-­ Dean,

Academic Affairs, in the Faculty of Kinesiology and Physical Education at the University of Toronto, Canada. She has expertise in sport psychology, interpersonal relations in sport, athlete maltreatment, and coach education. Jack Sugden is a lecturer of sport management and development at Edge Hill University, UK. His

ongoing research focuses on the role of sport in ethno-­racial relations and deeply divided societies. Ansgar Thiel is Director of the Institute of Sports Science at the Eberhard Karls University Tübingen, Germany, and holds a professorial chair for sport sociology. Ansgar studied sports science, psychology, and psychogerontology. Tine Vertommen is Lecturer and Researcher at the Thomas More University of Applied Sciences, Belgium, and at the Social Epidemiology and Health Policy Institute of the University of Antwerp, Belgium. Her research focuses on violence against child athletes and includes studies on the prevalence and impact of psychological, physical, and sexual violence. Jennifer J. Waldron is the Associate Vice President for Research and Innovation and Dean of the Graduate College at the University of Northern Iowa, USA, and Professor of Kinesiology. She is the Associate Editor of the Women in Sport and Physical Activity Journal and Co-­Organiser of the Social Justice in Sport and Exercise Psychology Symposium. Tom Webb is a senior lecturer in the School of Sport, Health and Exercise Science at the University of Portsmouth, UK. He is first author of the book Referees, Match Officials and Abuse: Research and Implications for Policy (Routledge, 2020), and author of Elite Soccer Referees: Officiating in the Premier League, La Liga and Serie A (Routledge, 2017). Karl Wharton is a senior lecturer in sport coaching in the Department of Sport, Exercise and

Rehabilitation at Northumbria University, UK. Karl has previously worked as a national coach for British Gymnastics and is a member of the International Federation of Gymnastics (FIG) Coaching Academy as a world expert in coaching pedagogy. Adam J. White is an interdisciplinary researcher in sport, education, and health at Oxford

Brookes University. He is co-­author of the book Sport, Theory and Social Problems (Routledge, xvi

Contributors

2017). Adam’s doctoral work investigated the role of contact sport within school physical education and school sport and the issues associated with injury. Chris Zehntner is a lecturer in personal development, health, and physical education in the School of Education at Southern Cross University, Gold Coast, Australia. His research investigates sociocultural issues central to sport coaching, coach education, and athlete abuse, focusing specifically on the power/knowledge nexus in sporting contexts.

xvii

Acknowledgements

First, I am very grateful to all the contributors to this Handbook for their hard work and for providing excellent chapters; the Handbook wouldn’t have been possible without you, and your efforts are appreciated. Sincere thanks also go out to Routledge’s Sport and Leisure Senior Publisher Simon Whitmore for being behind the Handbook from the start and to Editorial Assistant Rebecca Connor for her support in the production of the book. Thanks are also due to the much-­missed Celia Brackenridge for inspiring my interest in athlete welfare all those years ago and for her commitment and advocacy to improving the welfare of all involved in sport and physical activity. I am also thankful to Tom Cockburn, Paul Reynolds, Daniel Sage, Jimmy O’Gorman, and Rob Lake for their help and advice when compiling this Handbook and to all my academic colleagues in the United Kingdom and beyond who have supported me in my career and have become valued friends; special mentions here to Tine Vertommen, Bettina Rulofs, Philippa Velija, and Sylvie Parent. Thanks also go out to Matt Fearon, Paul Edgar, Jo McVeigh, Kristine Rose, and Julie Cook for their ongoing friendship and understanding while I was finishing this book during challenging circumstances for all and to all my family for their love and encouragement throughout. Sincere thanks also to Chris ‘Wrexham’ Murphy for his unwavering support (and occasional mockery) over the years I was putting this book together; your support and good humour was without parallel, and I will be forever thankful for this. And, finally, words cannot do justice to the depth of my gratitude to the much-­loved Anne Flintoff and Laura Purdy for their invaluable encouragement, positivity, and friendship. I would not have got to this point without you, and I thank you both from the bottom of my heart.

xviii

Introduction Melanie Lang

Introduction When Routledge’s Sport and Leisure commissioning editor, Simon Whitmore, approached me about the possibility of compiling a text on athlete welfare as part of the Handbook series, I was heartened – there have been so many positive developments in the understanding, policy, and practice of safeguarding athletes’ welfare globally over the past two decades, and athletes are, in many ways, better protected than ever before. That Routledge was supportive of such a book was, in itself, encouraging and indicated a belief that there was a market for a text on this topic. The significance of this is not to be underestimated; as relatively recently as the early 2000s, the late professor Celia Brackenridge, OBE, a pioneer of research and advocacy in the prevention of sexual violence and child protection in sport, struggled to find an outlet for her work; it was labelled either “too personal” or, as it related specifically to sport, as having “nothing new to say on sexual abuse” (Brackenridge, 2001, p. 153). But Routledge’s suggestion for a new compilation on athlete welfare also gave me pause for thought. While in many ways much has changed for the better in terms of the welfare of athletes over the past two decades, much has also remained the same, as the chapters in this book attest. It is now widely accepted that participation in sport has the potential to bring with it not only physical benefits but a wealth of psychological, educational, and social benefits (Micheli et al., 2011; United Nations Children’s Fund, 2004). Additionally, the 2000s witnessed a sea change in how governments, sports organisations, and sport stakeholders such as policymakers, managers, athletes, and coaches approach the welfare of those involved in sport. Sport as a global institution has begun to face up to the myriad issues within its ranks that can compromise the health, safety, and integrity of those involved. In this relatively short period, national and international legislation and policy frameworks have been established to promote the health, safety, and well-­being of athletes; awareness-­raising campaigns have proliferated; mechanisms for reporting concerns and allegations have been initiated; research studies have burgeoned; interventions have multiplied; and understandings of the issues that can compromise the welfare of athletes have expanded to incorporate a wider range of issues that can jeopardise the physical, emotional, sexual, psychological, social, intellectual, and spiritual welfare of athletes of all ages and across all levels of sport. Indeed, there can be little doubt that there are more safeguards in place for athletes now than ever before. 1

Melanie Lang

Yet there can also be no doubt that the welfare of athletes (and other stakeholders in sport) is still regularly being put in jeopardy (Lang & Hartill, 2015). David (1999, pp. 53–54) goes as far as to argue that modern organised sport is “an environment in which the most respectable aspects of sports, such as its educative scope, sportsmanship and physical and mental wellbeing, are seriously threatened”, and it’s not difficult to see why. Shocking stories of the sexual harassment, abuse, and exploitation of (adult and child, male and female) athletes and of sports authorities’ frequent mishandling of these have garnered significant media headlines across the global in recent years; the Larry Nassar case in USA Gymnastics and the case of Barry Bennell and others in football in the United Kingdom may be among the best known, but allegations of widespread sexual violence in elite judo, taekwondo, and speed skating in South Korea; in gymnastics, hockey, and cricket in India; and in football in Brazil have also hit headlines in the last decade (see Associated Press, 2019; BBC News, 2018; Lockwood, 2018; Mishra, 2015; Reuters, 2010). Perhaps less surprising is the increase in interest from researchers and the media in a wider range of welfare issues faced by athletes – from sexism and racial discrimination to bullying, hazing (i.e. initiation) rituals, concussion and other serious injuries, and mental health issues, among others (Cunningham, Pickett & Andrew, 2018; Denison & Kitchen, 2015; Farrington, Hall, Kilvington, Price & Saeed, 2014; Finch, Mitchell & Boufous, 2011; Ingle, 2019; Plan International Australia, 2019; Schinke, Stambulova, Si & Moore, 2018; Von Rosen, Kottorp, Fridén, Frohm & Hejine, 2018). This expansion in the types of issues being recognised as damaging to athletes’ physical and mental health signals a shift in how athlete welfare is conceptualised.

Defining athlete welfare What do we mean by athlete welfare? The term isn’t as easy to define as one might think. An admittedly unscientific straw poll of colleagues and friends who work inside and beyond sport revealed that the term is most frequently connotative of negative experiences in sport – instances of child sexual abuse and ‘pushy’ parents, and ways of protecting athletes from these, were the most commonly mentioned. Interesting, then, that the term as officially defined has a more positive meaning. In British English, the term ‘welfare’ dates from around 1300, stemming from the Old English term ‘wel faran’, a noun meaning ‘the condition of being or doing well’  – a combination of the adverb ‘wel’ and the verb ‘faran’, meaning ‘get along’ (Online Etymology Dictionary, 2020). This definition extends to the current day, with the Cambridge English Dictionary (2020) defining ‘welfare’ as “physical and mental health, happiness and prosperity, especially of a person”.1 In this usage, then, the term is inherently positive, in that it relates to an individual’s happiness, as well as inherently broad ranging, relating not only to one’s physical wellness (i.e. the absence of physical illness) but also one’s mental wellness (i.e. the absence of mental illness), as well as to one’s overall contentment and success, in all senses of the term (i.e. physical, emotional, psychological, sexual, financial, social, behavioural, intellectual, etc.). It is this meaning of ‘welfare’, coupled with a broad understanding of the term ‘athlete’ to include anyone involved in sport at any level, that I was concerned with when compiling this text; that is, I understand athlete welfare as anything that may affect the physical and/or mental health, happiness/contentment, success, and prosperity of those involved in sport. As such, I was keen to include in the Handbook chapters on a wide range of issues – some well known and widely written about, others far less so – that can compromise the physical, emotional, psychological, intellectual, social, behavioural, and spiritual welfare of athletes of all ages, as well as the approaches taken by national and international sport organisations to mitigate these. 2

Introduction

Indeed, while sport has historically been regarded as occupying an untouchable moral high ground, thanks in large part due to its reliance on the benevolence of volunteers and the host of physical, educational, and social skills it can develop (Brackenridge, 2001; Micheli et  al., 2011; United Nations Children’s Fund, 2004), this is changing. There is growing scientific and anecdotal evidence that sport is a sociocultural context that places athletes at particularly high risk of a range of welfare concerns. In other words, the well-­established benefits of involvement in sport are not automatic. Indeed, sport’s traditional association with moral goodness may even serve to obscure understandings and recognition of the harms that can be caused within it. While space constraints prevent me from going into substantial detail in this chapter on why sports culture renders athletes particularly vulnerable to experiences that may negatively affect their welfare (Vanden Auweele, 2016, provides an excellent discussion of this), a brief overview is warranted.

Understanding the risks to athletes It has been recognised for some time that sport is predicated on hierarchical power relations, with athletes of all ages having access to fewer sources of power than other stakeholders, especially coaches and team staff (i.e. managers, physios, medical staff) (Brackenridge, 2001; Lang, 2010; see Brackenridge, 2001, pp. 82–85 for a fuller discussion on sources of power in sport). In recent years, this understanding has expanded to recognise that unequal power dynamics also exist between lower-­and higher-­status athletes and between athletes and their parents (Skolnikoff & Engvall, 2014; Steinfeldt, Vaughan, LaFollette & Steinfeldt, 2012). The potential for abuse and exploitation exists in any organisational culture where there are perceived or actual power differences (Holligan, 2018; Kirby, Greaves & Hankivsky, 2000). Sport is one such culture. Sport is also a culture where conformity to potentially damaging norms and behaviours is expected and encouraged – unquestioning deference to the authority of the coach and others with assumed ‘expertise’; adherence to idealised forms of masculinity and discourses of mental toughness and physical preparation that encourage risk taking and playing through pain and injury; compliance with intensive and abusive training regimes and objectifying practices, such as weighing and measuring of athletes’ bodies (Connell  & Messerschmidt, 2005; Hughes  & Coakley, 1991; Jacobs, Smits  & Knoppers, 2017; Lang, 2010, 2015; McMahon  & Penney, 2013). Sadly, abusive coaching practices and behaviours are often structurally and culturally embedded in sport and have come to be the dominant model for success; such behaviours are rationalised as ‘functional’ – not only leading to improved performance and, therefore, success but necessary for this. In such a culture, where abusive practices and behaviours are normalised, often even exalted, athletes have few alternative, more ethical modes of behaviour to draw upon and model (Lang, 2010). That athletes are often, as a result of their training and competition regimens, isolated from wider protective structures, such as family and educational networks, further compounds their vulnerability. The performative and highly contested culture of sport also adds to athletes’ vulnerability. Athletic careers are dependent on success: Athletes’ progression in sport, whether that means being picked for the team at a recreational level or being named on an elite squad, is linked to accomplishment of a particular goal (i.e. a qualifying time, being the fastest in a particular event). Similarly, a coach’s progression up the career ladder, whether that means working with the top squad at a club level or being appointed as a national-­level coach, is often dependent on them demonstrating success by producing winning athletes. The common practice of ‘money for medals’ (i.e. governments linking financial support for sports organisations to international 3

Melanie Lang

rankings and medal hauls) also means national sports organisations are invested in producing elite athletes to ‘prove’ their worth. In such a results-­driven climate, it is easy to see how performance can come to trump the welfare of those involved in sport and how athletes come to be constructed as objects to fulfil the needs of multiple others (i.e. coaches, parents, national sports organisations, sponsors). These and other factors make it easy to see how the culture of sport can serve to make athletes vulnerable to multiple risks to their welfare, as well as how it can discourage athletes who have had negative experiences in sport from speaking out and facilitate inaction and denial from sports authorities and bystanders (Cooky, 2012; Sanderson & Weathers, 2019). Indeed, the chapters in this Handbook not only highlight the wide range of issues faced by athletes that can compromise their welfare, they also reveal the particular role played by sports culture in these. There is undoubtedly a growth in interest in athlete welfare in general and in specific issues that put the welfare of athletes at risk. I hope this Handbook plays a small part in contributing to further developing this interest and extending our understandings in this critical area.

Overview and omissions Comprising 34 newly commissioned chapters across seven sections, this Handbook provides a comprehensive collection of the latest cutting-­edge research on a range of topics related to athlete welfare from authors from around the world. Compiling and editing such an extensive text is no easy task, and the end result is not without its limitations. Even with contributions from 59 authors from 14 countries, representing three continents and a variety of disciplines, it has not been possible to cover everything. Indeed, I acknowledge there are significant gaps. In particular, I am aware that developments and authors from the Global South are woefully under-­represented. This was not through a lack of effort to recruit authors working in these regions; academic research relating to athlete welfare issues is embryonic in the Global South, although there are pockets of research emerging in parts of Africa, Asia, and South America, particularly around the protection of children from (predominantly sexual) abuse and the labour rights of migrating athletes (for example Agergaard & Ungruhe, 2016; Dilsad Ahmed et al., 2018; Solstad & Strandbu, 2019). Although the issues covered in this Handbook may well be relevant to countries beyond those in which the chapter authors are based, the lack of coverage of athlete welfare as it relates to policy and practice in the Global South remains a significant omission. Moreover, while I am pleased to have been able to include in the Handbook chapters on welfare issues specific to certain marginalised groups, chapters overwhelmingly focus on experiences and developments as they relate to white, able-­bodied, heterosexual athletes. Equally, while the range of issues covered in the Handbook is broad, I recognise that many other topics and perspectives are missing. Doping, intensive training, financial abuse, match fixing, athletes’ rights as workers, and sex trafficking are among the welfare issues that have featured, albeit fleetingly, in the media and/or in previous academic work in recent years but that are, for various reasons, not covered in this text. Indeed, the scope of potential issues that can affect an athlete’s welfare is so great that there are many other topics beyond these that are equally worthy of consideration. It is also the case that much of the existing work in this area stems from sociologists, psychologists, and philosophers of sport, and this is reflected in the disciplinary backgrounds of many chapter authors. Therefore, what this Handbook represents is a snapshot of existing evidence relating to athlete welfare. Just a decade ago, the range of topics and authors that such a book would have been able to draw together would have been significantly narrower. It is hoped that in the next 4

Introduction

decade and beyond, the field will expand yet further, deepening our understanding of issues that impact athletes’ welfare and of approaches to preventing and managing these.

Structure of the handbook Part 1 centres on understandings of athlete welfare. In the first chapter, I trace developments in international policy and discourse relating to athlete welfare. The chapter identifies how sports policy has shifted from a focus in the mid-­1970s on the promotion of equality for women in sport to a contemporary focus on the prevention of sexual violence perpetrated against athletes, and especially children in sport. The implications for athletes and sports bodies of this narrow focus on this one particular form of violence are discussed. The chapter also highlights how growing interest in and implementation of human rights in sport offers the potential for a new, more holistic understanding of athlete welfare in future. In Chapter 2, Leon Culbertson discusses ‘scientism’ and the potential damage that can result from this way of thinking about athletes. He argues that scientistic conceptions of athletes contribute to the development and perpetuation of understandings of performance enhancement in sport that are detrimental to athlete welfare by, among others, justifying potentially dangerous practices. In Chapter 3, Geoffery Z. Kohe and Laura Purdy situate the increasing attention being paid to elite athletes’ career transitions and concomitant athlete career transition programmes within a context of welfare provision. Drawing on ethics of care theory and paying special attention to the UK-­based Duty of Care in Sport Review (Grey-­Thompson, 2017), they highlight care concerns and consider how care practices have become bureaucratised within the sports sector. Extending the discussion of the ethics of care in sport, Emily McCullogh and Parissa Safai explore the relationship between welfare and care in Chapter 4. They argue that shame and shaming articulate as practices that emphasise the lack of athlete care and welfare and as social phenomena intimately connected to hierarchies of power in sports coaching. They conclude that coaching is, by its nature, a caring profession and one that should therefore be responsible for the care of athletes. Part 2 moves the debate on to some of the most frequently discussed contemporary athlete welfare concerns. In Chapter 5, Natalie Barker-­Ruchti, Astrid Schubring, and Carly Stewart discuss gendered violence in sport. Locating their discussion within Women’s Artistic Gymnastics, they fuse a sociological perspective of violence and a feminist perspective of gender to explore how a theorising of violence as gendered can help us better recognise, explain, and potentially transform the violence experienced by athletes. In Chapter  6, Alixandra Krahn explores a form of abuse that often goes unchallenged within sport – psychological abuse, more specifically verbal forms of psychological abuse. Drawing on data from a study with competitive and high-­performance women’s volleyball coaches, Krahn unpicks coaches’ perceptions of verbal forms of psychological abuse. She concludes by highlighting how these insights could be used to improve athlete welfare policy and coach education in order to develop more ethical coaching practice. Chapter  7 offers a new perspective on an established welfare issue: Playing hurt. Jochen Mayer, Felix Kühnle, and Ansgar Thiel present a new holistic decision-­making framework that integrates empirical findings on health and injury management in elite sport with knowledge from presenteeism research to explain why athletes play and compete through pain or injury. Sticking with the theme of injury, in Chapter 8, Adam J. White discusses concussion in physical education and school sport. Using statistics that demonstrate the high rates of traumatic brain injury and long-­term neurodegeneration resulting from participation in rugby union, White dismantles commonly used arguments relating to informed consent and the acceptability of risk. He concludes that the 5

Melanie Lang

removal of contact in physical education and school sport rugby union is the only logical and viable solution to safeguarding young players. Chapters 9 and 10 focus on peer-­to-­peer violence. In Chapter 9, Miguel Nery, Carlos Neto, António Rosado, and Peter K. Smith discuss bullying among adolescent athletes. Reporting on the first study of its kind in sport, Nery and colleagues describe and analyse the incidence and nature of bullying in Portuguese sport. They also present a series of useful guidelines that sports organisations, coaches, parents, and athletes can adopt to prevent and manage this perennial problem. Meanwhile, in Chapter 10, Jennifer J. Waldron provides a framework for understanding and responding to hazing, also sometimes referred to as initiation rituals, in sport. Waldron explains how variables identified in previous empirical work on hazing – such as athletic identity, sport status, power, team cohesion, and groupthink  – can be used to devise a comprehensive model that may assist practitioners in implementing hazing intervention strategies. In the final chapter in this section, Sylvie Parent, Judith Kotiuga, Tine Vertommen, and Kristine Fortier draw attention to the topic of self-­directed violence in sport. Parent and colleagues identify self-­directed violence as including behaviours such as training or competing while injured or in pain, using performance-­enhancing agents or methods (i.e. doping), adopting harmful weight-­management techniques, and punishing oneself after a bad performance. They go on to explore the links between these behaviours in athletes and athletes’ experiences of other forms of violence, such as maltreatment from an authority figure in sport. Part 3 addresses mental health issues in sport. Awareness of mental health issues has grown exponentially in recent years in and beyond sport, with many high-­profile athletes coming forward to discuss their experiences of depression, anxiety, and other mental health issues. In Chapter  12, Brad Donohue and Davy Phrathep explore the factors that influence the development and maintenance of mental health symptomology in athletes as well as the latest programmes to address these, such as assessment/screening measures, service engagement methods, and interventions. The chapter concludes by offering concrete suggestions to inform policy and assist sport organisations in the integration of evidence-­supported approaches to mental health optimisation in athletes. In Chapter 13, Ashwin L. Rao turns to the topic of suicide among athletes. He notes that athletes are often viewed as models for health and wellness yet face many unique stressors that challenge their mental health and can lead to suicidal ideation. The chapter overviews suicide rates and risk factors in and beyond sport before identifying the challenges and strategies for the evaluation and treatment of athletes from all levels of sport who experience suicidal thoughts. In Chapter 14, Carwyn Jones focuses on addiction among athletes. He examines definitions of addiction, diagnostic criteria, theories about how and why addiction occurs, and how and why individuals recover from their addictions. In doing so, Jones identifies what role, if any, sport, sports culture, and a sporting career have on preventing, predisposing to, or recovering from, addiction. In the final chapter in this section, Jenny McMahon explores how pressure on athletes to achieve a culturally accepted athletic (read: lean) body shape can lead to disordered eating and eating disorders. She proposes strategies for sporting organisations to adopt to prevent this, namely adopting an athlete-­centred coaching approach, use of narrative pedagogy to educate athletes and coaches about disordered eating practices, and the use of narrative to encourage coaches to reflect on their coaching practice. Part 4 turns to equity and inclusion. To be able to enjoy the benefits of sports participation, everyone needs to be able to access sport and take part in an environment free from violence and abuse. For this reason, ensuring equity and inclusion are central to maintaining athlete welfare. In addition, certain groups are more vulnerable to various forms of violence and abuse; disabled people, elite athletes, and those identifying as LGBT seem to be at particular risk (Vertommen 6

Introduction

et  al., 2015). Existing athlete welfare research that has included marginalised groups in their sample is limited, and studies that focus on welfare issues as they relate specifically to marginalised groups in sport are few and far between outside of those that discuss inclusion and discrimination. As such, little is known about whether or how welfare issues for marginalised groups in sport are heightened and/or different to those of other sports participants. Much more work needs to be done in this area, and this section represents a tentative step towards growing understandings in this area. In Chapter 16 on the welfare of disabled people in sport, Hayley Fitzgerald draws together conversations about disability, sport, and welfare, highlighting how it is crucial that sports participants, including those with disabilities, be recognised as having fluctuating needs and circumstances. She argues that nurturing sensitive and reflective practitioners will go some way to supporting disabled people to have positive, fulfilling, and safe sporting experiences. In Chapter 17, Alex Manning shows how racially and ethnically diverse spaces of youth soccer serve as a contested terrain where race is (re)produced, negotiated, and challenged. He goes on to highlight the consequences of overt and subtle forms of racism in this setting, including social and psychological harm to athletes, drop out, and reduced opportunities to experience the benefits of sport participation. Some of the same concerns are raised in Ali Greey’s chapter on locker rooms as a site of trans exclusion. Reporting the first study of its kind, Greey discusses trans peoples’ experiences of binary-­gendered locker rooms and the impact of this on trans athlete welfare. They also assess initiatives being used by institutions and facilities to advance trans-­inclusivity in locker rooms and provide practical suggestions for how to make locker rooms more trans-­inclusive. Part 5 draws attention to a series of topics and contexts that are new to the athlete welfare landscape. While research on all welfare issues in sport has a relatively short history, some topics have already received substantial attention (i.e. sexual harassment, sexual abuse, inclusion and discrimination). The chapters in this section highlight new and emerging areas of research relating to the welfare of athletes and other stakeholders in sport. In Chapter 19, Emma Kavanagh, Chelsea Litchfield, and Jaquelyn Osborne report on the potential for online spaces to become perilous for athletes. They define various forms of online harassment and abuse and discuss ways of enhancing digital safeguarding to better protect athletes and other stakeholders. Commercial sponsorship of elite child athletes comes under the spotlight in Chapter 20. Using the framework of children’s rights, Froukje Smits discusses the impact of being a sponsored action sport athlete on children’s educational, social, and physical welfare, arguing that sponsorship encourages practices that are not always in child athletes’ best interests. Chapter 21 reports on the well-­being of professional basketball athletes contracted to teams in conflict zones such as Russian-­annexed Crimea. Laura Purdy, Geoffery Z. Kohe, and Rūtenis Paulauskas highlight the experiences of migrant and ‘local’ sports workers living within conflict zones, the role played by national and international federations in safeguarding athletes in this context, and the impact of the conflict on athletes’ career plans. The welfare of migrant athletes also features in Chapter 22. David Lakisa, Jack Sugden, and Brent McDonald focus on the welfare challenges faced by Pasifika rugby footballers living and working away from their home countries. In particular, they focus on the importance of and obstacles to spiritual well-­being among professional athletes in the Pacific islands and those playing in Australia and the support mechanisms needed to promote players’ spiritual and emotional welfare. In Chapter 23, Dean M. Ravizza considers the welfare of young people involved in sport-­ for-­development initiatives. Ravizza demonstrates the potential for sport to strengthen the protective factors of youth at risk of becoming engaged in violent extremism and describes the critical roles of coaches and community stakeholders in contributing to the reinforcement of positive factors that enhance social inclusion. Meanwhile, in Chapter 24, Colin Harris and 7

Melanie Lang

Mike Hartill consider the role of sexual abuse survivors in research on sexual violence in sport. Offering a co-­constructed account of the research process, they discuss the experiences of participating in research as ‘survivors’ of child sexual abuse in sport. The final chapter in this section moves away from a focus on athletes to considering the welfare of another key stakeholder in sport: Match officials. Tom Webb and Paul Gorczynski discuss the impact of routine exposure to physical and/or verbal abuse from athletes, coaches, and spectators on match officials’ physical and mental health. Interlacing match officials’ experiences of being the target of abuse with the existing pressures match officials face when carrying out their duties, the chapter concludes by presenting a new conceptual model of the factors that influence match official mental health. Part 6 focuses on key sport stakeholders and the role they play in promoting, and sometimes hindering, athlete welfare. Chapter  26 centres on parents. Camilla J. Knight, Olivier Y. Rouquette, and Maita G. Furusa unpack the complexity of the parent role within youth sport, reviewing the positive and negative roles of parents in sport and in safeguarding children in sport. They conclude by outlining key strategies that clubs, coaches, and parents should take to ensure that parents are able to be involved in sport in the most positive way possible. Meanwhile, in Chapter  27, Chris Zehntner turns our attention to athletes themselves and their role in accepting and normalising damaging coaching practices. Zehntner discusses the ways that athlete abuse is enacted within the coach–athlete relationship. Reporting on a study of the Australian women’s cycling development team, he reveals how female cyclists buy into questionable coaching practices and contribute to the proliferation of these to achieve national selection. Susanne Johansson also focuses on athletes in Chapter 28, discussing rarely talked-­ about romantic relationships between adult athletes and their coaches. She highlights how the benefits stemming from such relationships (i.e. feelings of safety, trust, understanding, and support) can support athletes’ welfare but that such relationships can also be damaging for athletes, and thus there is a need to examine rather than ignore adult coach–athlete relationships. The final chapter in this section, Chapter 29, charts the intended and unintended consequences of policy to safeguard and protect children on coaches, child athletes, and their parents. Andrea Scott-­Bell, Karl Wharton, and Paul Potrac highlight the emotional turmoil of those responsible for performing safeguarding policy in light of the ongoing moral panic around child safety in some sports contexts. Part 7, the final section, addresses prevention approaches and initiatives adopted by governments and sports organisations to mitigate athlete welfare concerns. Chapter  30 focuses on developments from the world’s most powerful sports organisation, the International Olympic Committee. Margo Mountjoy, Kirsty Burrows, and Susan Greinig provide a comprehensive overview of initiatives in place during and beyond the Olympic and Youth Olympic Games to achieve ‘safe sport’ for all athletes. These include policies on reporting and managing allegations of welfare breaches, a series of Consensus Statements and scientific publications, athlete and team physician educational initiatives, and the supporting of research centres and athlete protection research around the world. In Chapter  31, Maria Papaefstathiou and I  highlight the strengths and limitations of criminal record checking as an approach to preventing known (and, in some cases, suspected) offenders from gaining access to vulnerable groups in sport, such as children. Through a case study of how these checks operate in one European country – Cyprus – we argue that criminal record checking must form one part of a comprehensive, evidence-­based strategy that seeks to transform sports culture and practice. Chapter 32 explores the prevention of sexual violence at a local level in sports clubs in Germany. Bettina Rulofs reports on an evaluation of a pilot project involving sports organisations in the North Rhine-­Westphalia region of the country. She notes that many sports clubs in Germany are not 8

Introduction

sufficiently protecting athletes from sexual violence and argues that more specific efforts are needed to support clubs in this endeavour. Tine Vertommen and Sylvie Parent highlight the problems in determining the prevalence of violence and abuse in sport in Chapter 33. They begin by offering an overview of existing data on various forms of interpersonal violence in sport before discussing the myriad challenges in establishing such figures. Finally, in Chapter 34, Joseph Gurgis, Gretchen Kerr, and Ashley Stirling offer a way forward for coaches wishing to develop athlete-­centred coaching practices to promote athlete welfare. Applying the transtheoretical model of behaviour change for the first time to coaching practice, they show how coaches can be guided through a process of behavioural change to lead to the adoption of athlete-­centred and safeguarding coaching practices.

Note 1 It is this meaning that led, with the creation in the United Kingdom of the welfare state in the 1940s, to the new meaning of ‘welfare’ as financial and social support to assist disadvantaged groups.

References Agergaard, S. & Ungruhe, C. (2016). Ambivalent precarity: Career trajectories and temporalities in highly skilled sports labour migration from West Africa to Northern Europe. Anthropology of Work Review, 37(2), 67–78. Associated Press (2019, January 23). South Korea unveils biggest ever investigation into abuse in sport. The Guardian. Retrieved from: www.theguardian.com/world/2019/jan/23/south-­korea-­biggest-­sexual­abuse-­sport-­investigation BBC News (2018, May 1). Brazil gymnasts accuse ex-­coach Lopes of sexual abuse. BBC News. Retrieved from: www.bbc.co.uk/news/world-­latin-­america-­43966284 Brackenridge, C. H. (2001). Spoilsports: Understanding and preventing sexual exploitation in sport. London: Routledge. Cambridge English Dictionary (2020). Welfare (noun). Retrieved from: https://dictionary.cambridge.org/ dictionary/english/welfare Connell, R. & Messerschmidt, J. (2005). Hegemonic masculinity: Rethinking the concept. Gender and Society, 19, 829–859. Cooky, C. (2012). Success without honour: Cultures of silence and the Penn State scandal. Cultural Studies ←→ Critical Methodologies, 12, 326–329. Cunningham, G. B., Pickett, A. C. & Andrew, C. (2018). Trans prejudice in sport: Differences from LGB prejudice, the influence of gender, and changes over time. Sex Roles, 78(3), 220–227. David, P. (1999). Children’s rights and sports young athletes and competitive sports: Exploit and exploitation. The International Journal of Children’s Rights, 7(1), 53–81. Denison, E. & Kitchen, A. (2015). Out on the fields: The first international study on homophobia in sport. Sydney: Australian Sports Commission/Federation of Gay Games. Retrieved from: www.outonthe fields.com Dilsad Ahmed, M., van Niekerk, R. L., King Yan Ho, W., Morris, T., Baker, T., Ali Khan, B. & Tetso, A. (2018). Female student athletes’ perceptions of acceptability and the occurrence of sexual-­related behaviour by their coaches in India. International Journal of Comparative and Applied Criminal Justice, 42(1), 33–53. Farrington, N., Hall, L., Kilvington, D., Price, J. & Saeed, A. (2014). Sport, racism and social media. London: Routledge. Finch, C. F., Mitchell, R.  & Boufous, S. (2011). Trends in hospitalised sport/leisure injuries in New South Wales, Australia: Implications for the targeting of population-­focused preventive sports medicine efforts. Journal of Science and Medicine in Sport, 14, 15–21. 9

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Grey-­Thompson, T. (2017). Duty of care in sport: Independent report to government. Retrieved from: https:// assets.publishing.service.gov.uk/government/uploads/system/u ploads/attachment_data/file/610130/ Duty_of_Care_Review_-­_April_2017__2.pdf Holligan, C. (2018). Exploring a taboo of cultural reproduction. British Journal of Sociology of Education, 39(4), 535–550. Hughes, R. & Coakley, J. (1991). Positive deviance among athletes: The implications of over conformity to the sports ethic. Sociology of Sport Journal, 8(4), 307–325. Ingle, S. (2019, October 22). Landmark study reveals link between football and dementia. The Guardian. Retrieved from: www.theguardian.com/football/2019/oct/21/landmark-­study-­reveals-­link-­between-­ football-­dementia Jacobs, F., Smits, F. & Knoppers, A. (2017). “You don’t realise what you see!”: The institutional context of emotional abuse in elite youth sport. Sport in Society, 20(1), 126–143. Kirby, S., Greaves, L. & Hankivsky, O. A. R. (2000). The dome of silence: Sexual harassment and abuse in sport. Halifax, NS: Fernwood. Lang, M. (2010). Surveillance and conformity in competitive youth swimming. Sport, Education and Society, 15(1), 19–37. Lang, M. (2015). “None of the kids are allowed to eat junk at the pool”: Discourses of “optimal” nutrition in competitive youth swimming and the impact on athlete welfare. The International Journal of Sport and Society: Annual Review, 5(1), 11–22. Lang, M.  & Hartill, M. (2015). Safeguarding, child protection and abuse in sport: International perspectives in research, policy and practice. London: Routledge. Lockwood, S. (2018, April 29). Child abuse scandal reaches top of Brazilian football. Sky News. Retrieved from: https://news.sky.com/story/child-­abuse-­scandal-­reaches-­top-­of-­brazilian-­football-­11351751 McMahon, J. A. & Penney, D. (2013). (Self-­) surveillance and (self-­) regulation: Living by fat numbers within and beyond a sporting culture. Qualitative Research in Sport, Exercise and Health, 5, 157–178. Micheli, L., Mountjoy, M., Engebretsen, L., Hardman, K., Kahlmeier, S., Lambesrt, E., Ljungqvist, A., Matsudo, V., McKay, H. & Sundberg, C. J. (2011). Fitness and health of children through sport: The context for action. British Journal of Sports Medicine, 45, 931–936. Mishra, R. (2015, May  7). Five shocking incidents of harassment and sexual abuse of Indian female athletes. Retrieved from: www.india.com/sports/5-­shocking-­incidents-­of-­harassment-­and-­sexual-­abuse-­of-­ indian-­female-­athletes-­375979/ Online Etymology Dictionary (2020). Welfare. Retrieved from: www.etymonline.com/search?q=Welfare Plan International Australia (2019). Social media commentary of sportswomen and sportsmen. Melbourne: Plan International Australia. Retrieved from: www.plan.org.au/-­/media/plan/images/learn/who-­ we-­are/blog-­media-­images/2019/240419-­snapshot-­analysis/plan-­international-­australiasnapshot-­ analysissocial-­media-­commentary-­of-­sportswomen-­and-­sportsmenfin.pdf?la=en&hash=4261B77794F 748501C28E716B4E2D97F748E7146 Reuters (2010, January 18). India sports ministry says 35 sexual harassment complaints in 2011–19. ARY News. Retrieved from: https://arynews.tv/en/india-­sports-­sexual-­harassment/ Sanderson, J. & Weathers, M. R. (2019). “Every time someone comes forward, it makes it easier for the next survivor to be heard”: Sport as a triggering agent to break the silence of child sexual abuse. Communication Quarterly, 67(3), 333–353. Schinke, R. J., Stambulova, N. B., Si, G. & Moore, Z. (2018). International society of sport psychology position stand: Athletes’ mental health, performance, and development. International Journal of Sport and Exercise Psychology, 16(6), 622–639. Skolnikoff, J. & Engvall, R. (2014). Young athletes, couch potatoes, and helicopter parents: The productivity of play. New York: Rowman & Littlefield. Solstad, G. M. & Strandbu, A. (2019). Faster, higher, stronger . . . safer? Safety concerns for young athletes in Zambia. International Review for the Sociology of Sport, 54(6), 738–752. Steinfeldt, J. A., Vaughan, E. L., LaFollette, J. R. & Steinfeldt, M. C. (2012). Bullying among adolescent football players. Psychology of Men and Masculinity, 13(4), 340–353. United Nations Children’s Fund (2004). Sport, recreation and play. Geneva: UNICEF. 10

Introduction

Vanden Auweele, Y. (2016). Restoring sport’s integrity: Beyond ad-­hoc solutions in challenging aberrations in sport. In Van Auweele, Y., Cook, E. & Parry, J. (Eds.), Ethics and governance in sport: The future of sport reimagined (pp. 18–26). London: Routledge. Vertommen, T., Schipper-­van Veldhoven, N., Wouters, K., Kampen, J., Brackenridge, C. H., Rhind, D. J. A., Neels, K. & van den Eede, F. (2015). Interpersonal violence against children in sport in the Netherlands and Belgium. Child Abuse and Neglect, 51, 223–236. Von Rosen, P., Kottorp, A., Fridén, C., Frohm, A. & Hejine, A. (2018). Young, talented and injured: Injury perceptions, experiences and consequences in adolescent elite athletes. European Journal of Sport Science, 18(5), 731–740.

11

Part I

Conceptualisations of athlete welfare

1 Developments in international policy on athlete welfare Melanie Lang

Introduction The wide range of issues covered in this Handbook reflect the journey that sport has been on in recent decades in terms of understanding and developing approaches to athlete welfare. During this time, the focus of legislation and policy and concomitant terminology have shifted in light of changes to prevailing understandings and values. This chapter traces these developments, particularly those in international policy relating to athlete welfare. I identify how sports policy has shifted from a focus in the mid-­1970s on the prevention of sex discrimination and the promotion of equality for women in sport to a contemporary focus on the prevention of sexual violence against athletes, and especially against children in sport. The implications for athletes and sports bodies of this narrow focus on one particular form of abuse are also discussed. The chapter then highlights how growing recognition and implementation of human (and children’s) rights in sport offers the potential for a new, more inclusive understanding of athlete welfare in the future.

From promoting gender equality to preventing sexual violence The range of issues covered in this Handbook is reflective of the journey that sport has been on in recent decades to safeguard and promote the welfare of those involved. During this time, the focus of legislation and policy, and concomitant terminology and approaches to athlete welfare, have shifted in light of changes to prevailing understandings and values. The earliest steps in sports policymakers’ efforts to promote athlete welfare have their roots in two key developments from the 1970s: Second-­wave feminism’s critique of patriarchal privilege and the anti-­doping movement that gained prominence following the East German doping scandal. By the mid-­1970s, radical feminist accounts of men’s oppression of women had put male violence against women (and later children) firmly on the agenda (LeGates, 2001). At the same time, the unprecedented success in international competitions of athletes from the then-­German Democratic Republic and the Soviet Union, alongside whispered murmurings of widespread enforced doping from athletes who had fled the regimes, raised the profile of doping in sport (Ungerleider, 2001; Kalinski, 2017). Both these events shaped international sports policy, particularly in Europe. The Council of Europe, a Europe-­wide intragovernmental organisation that established the European 15

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Convention on Human Rights (European Court of Human Rights/Council of Europe, 2010), is one of the longest standing and most active institutions in terms of the development of international policy relating to the welfare of athletes. In 1975, it produced the European Sport for All Charter (Council of Europe, 1975), which set a common programme for sport policies across Europe and beyond. For the first time in sports policy, this made reference to sport as a setting where violence and exploitative practices can occur and made clear sport’s responsibility for safeguarding athletes’ welfare, stating: Methods shall be sought to safeguard sport and sportsmen from exploitation for political, commercial, or financial gain, and from practices that are abusive and debasing. (Council of Europe, 1975, Article V) While doping has remained high on the agenda of sport policymakers since this period, the reason for this has, at least until relatively recently, been efforts to promote fairness in competition – a so-­called level-­playing field for all – and broader concerns about the integrity of sport rather than on the welfare implications of banned substances, such as the impact on athlete health and well-­being (Kayser, Mauron & Miah, 2007). Meanwhile, sports policymakers and national and international organisations continued to develop initiatives to promote gender equity from the mid-­1970s, though the focus for the prevailing decade tended to be on preventing sex discrimination (Brackenridge, 2001). By the mid-­1990s, a shift had occurred and concerns about gender inequality and sex discrimination in sport were largely replaced by a focus on the sexual abuse and exploitation of athletes, especially child athletes. Indeed, within a decade, Brackenridge (2004, p. 322) argued the protection of children, especially against sexual violence, had overtaken gender equity as a policy priority in sport. There were two main reasons for this shift. The first was the emergence in the early 1990s of evidence from feminist researcher-­advocates in sport of the sexual harassment and sexual exploitation of women and girls by their coaches, primarily in the United Kingdom and Canada (see Brackenridge, 1991; Lenskyj, 1990, 1992). The second was a series of cases of child sexual exploitation by coaches in sport in Ireland, the United Kingdom, and Canada that received significant media attention (Brackenridge, 2001) – notably, former Irish Olympic swimming coach Derry O’Rourke, who was first investigated for sexually abusing girl swimmers in 1992; former Olympic swimming coach Paul Hickson, who was arrested in 1993 for sexually abusing female athletes and convicted two years later; and Canadian junior ice hockey coach Graham James, who was charged in 1996 with sexually assaulting two boy players and convicted the following year. All three cases were covered heavily by national and international media, sparking a moral panic around child sexual abuse in sport (Brackenridge, 2001; Lang & Hartill, 2015). Against this backdrop, the European Sport for All Charter was updated in 1992 to include specific mention of sport’s responsibility to protect women and child athletes from sexual harassment and abuse (Council of Europe, 1992a). In addition, the Charter was accompanied by the Code of Sports Ethics (Council of Europe, 1992b), which identified, among other issues, physical violence, sexual harassment, and sexual abuse as going against the principles of fair play and recommended that governments’ existing legislation and strategies to protect women and children be updated to include sport as a context where such violence occurs.

Problematising the current focus In many ways, the prevention of sexual violence, especially against children, remains the focus of sport policy to this day (Lang, Mergaert, Arnaut  & Vertommen, 2018), as sports 16

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organisations have been significantly slower to respond to non-­sexual forms of violence and abuse. At a European level, for example, the European Commission (2014, p. 4) listed “the fight against sexual violence and harassment in sport” as one of its funding priorities for 2014– 2020 as part of its plans to improve gender equality in sport. Multiple binding and non-­binding initiatives on the prevention and management of sexual violence in sport have also been issued at this level since the mid-­1990s (Mergaert, Arnaut, Vertommen & Lang, 2016). For example, the Resolution on the Prevention of Sexual Harassment and Abuse of Women, Young People and Children in Sport (Council of Europe, 2000) specifically urges Council of Europe Member States to develop national policies that define sexual harassment and sexual abuse in sport and raise awareness of these behaviours. Similarly, the Convention on the Protection of Children against Sexual Exploitation and Sexual Abuse (Council of Europe, 2007) and the Proposal for Strategic Actions on Gender Equality in Sport (European Commission, 2014) both focus heavily on protecting athletes, especially child athletes, from sexual exploitation and sexual abuse in sport (Mergaert et al., 2016). Similarly, at a national level, McVeigh and Lang (forthcoming) and Lang and Hartill (2015) chart how protection from child sexual abuse has been the driver behind policy developments in child protection in sport in most countries where action has been taken. Of course, there can be no doubt that all developments aimed at improving the welfare of athletes of any age are important and should be welcomed. However, just as Brackenridge (2004) was concerned in the mid-­2000s that the heightened attention being paid by sports policymakers to addressing child protection in sport was overshadowing developments in gender equity, so it can be argued that the high profile currently given to sexual forms of violence in sport risks eclipsing other, more prevalent and equally damaging athlete welfare concerns. In many ways, this is unsurprising; sexual violence is what Nelson (1986, p. 27) calls a ‘valance issue’ (see Lang & Pinder, 2017) – an issue that elicits a “strong, fairly uniform emotional response and does not have an adversarial quality”. In other words, there is limited public support for sexual violence or its perpetrators and so overwhelming support for developments to protect against it. However, this focus may inadvertently detract from protecting athletes from other welfare issues and from empowering athletes to speak out about their experiences of these; if discourse and policy focus on sexual violence at the expense of other forms of abuse and exploitation, other welfare issues risk being regarded as ‘less than’, not ‘real’ abuse that is worthy of attention and intervention. Equally, the most common target of existing strategies are children (Mergaert et al., 2016) – perhaps a reflection of dominant Western constructions of children as particularly vulnerable to abuse and exploitation and therefore in need of special protection (Kitzinger, 1997). For example, the European policies noted previously predominantly focus on the welfare of children in sport. Similarly, one of the most notable developments in international policy relating to athlete welfare in the last decade, the International Safeguards for Children in Sport (International Safeguarding Children in Sport Working Group, 2014), also focuses only on children. The International Safeguards were devised in 2012 based on similar protocols for sports organisations in the United Kingdom (see the NSPCC Sport England Child Protection in Sport Unit, 2018). In recognition that many sports organisations that operate internationally have limited expertise in safeguarding children and often limited sport-­specific information on this topic on which they can draw, the International Safeguards aim to help sports organisations develop strategies to proactively safeguard and protect children and promote their rights. As of 2019, 125 sports organisations had endorsed the International Standards, and a pilot evaluation suggests they show significant promise in encouraging sports organisations to adopt measures to protect children and promote their rights (Rhind & Owusu-­Sekyere, 2019). 17

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Children are, of course, deserving of protection. However, the emphasis in existing policy and prevention efforts on protecting children over other athletes ignores the fact that all athletes, regardless of age, are vulnerable to violence, abuse, and exploitation. Thus, while national and international sport policy has made great strides over the recent decades in acknowledging and rallying against a range of athlete welfare concerns, existing policy initiatives and discourse focus predominantly on the prevention of sexual violence in sport over other welfare issues and/or focus specifically on the protection of children from harm in sport over safeguarding all athletes. As such, there is still a significant way to go before the full spectrum of behaviours that can jeopardise the welfare of athlete of all ages is acknowledged and addressed.

Broadening the frame: human rights and sport In recent years, prevailing attitudes and policy approaches have begun to shift, reflecting a turn to a more holistic approach to athlete’s welfare and increased understanding that sport has a moral as well as a legal responsibility not only to safeguard those who take part from all forms of harm but also to integrate human rights. Awareness of and commitment to human rights has progressed steadily across the globe since the publication in 1948 of the Universal Declaration of Human Rights (UDHR; United Nations, 1948). The UDHR enshrines the basic rights and freedoms that are inalienable to all humans (Office of the High Commissioner of Human Rights, 2020). Within Article 25(2) of the UDHR, children are identified as warranting special rights (United Nations, 1948). This recognition eventually led to the creation of the United Nations Convention on the Rights of the Child (UNCRC), an international human rights treaty that lays out the basic rights and freedoms that apply to all children and young people.1 The UNCRC was based on the Declaration of the Rights of the Child, which was drafted in 1923 by Save the Children founder Eglantyne Jebb and first adopted in 1924 by the then-­intergovernmental organisation the League of Nations (Child Rights International Network, 2019). The Declaration was later expanded on by the United Nations and eventually became the UNCRC, which was adopted in 1989 and came into force the following year (UN General Assembly, 1989). While debate is ongoing about exactly what a ‘human right’ is or should be (see Barreto, 2013; Mitra, 2014; White, 1999), the UDHR includes the rights to life, liberty, and security of person; the right to freedom of thought and expression; the right to democratic representation; the right to non-­discrimination; the right to freedom from slavery or servitude; the right to work, rest, leisure, and education; and the right to protection from cruel, inhuman, and degrading treatment or punishment (United Nations, 1948). The UNCRC identifies similar rights for children and young people, grouped under the four guiding principles of: 1) non-­ discrimination, 2) the best interests of the child, 3) survival and development, and 4) respect for the views of the child (UN General Assembly, 1989). Importantly, while neither the UDHR nor the UNCRC specifically refers to sport, the rights established in these treaties apply as much to sport as to any other setting. As such, they offer an important framework for athlete welfare and have the potential to broaden our understanding of the risks to athlete welfare. Indeed, when human rights are taken as the starting point for the evaluation of sport and its practices, many traditional cultural practices are called into question. As the chapters in this Handbook illustrate, sports practice is not always aligned with human rights and can reproduce conditions in which violence towards and abuse of athletes are able to flourish (David, 2005; Donnelly, 2016). While sport was significantly later than other sectors to begin to embed human rights principles (David, 2005), by the mid-­2010s, developments in this regard were well underway. At the 18

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time of writing in spring 2020, numerous statements of rights inspired by the UDHR have been developed for sport, such as the Athlete Bill of Rights (The Centre for Sport and Society, 2009), the International Charter of Physical Education, Physical Activity and Sport (United Nations Educational, Scientific and Cultural Organisation, 2015), the Sporting Chance Principles on Sport and Human Rights (Sporting Chance, 2018), and the Declaration on Safeguarding the Rights of Child Athletes (World Players Association, 2018). Similarly, multiple organisations working in the area of general human rights in sport or specific areas of human rights in sport, such as the protection of athletes’ interests, have been established over the past 10 years, such as the European Elite Athletes Association (known as EU Athletes) (EU Athletes (2009), the Sport and Rights Alliance (2015), the Centre for Sport and Human Rights (2018b), and the World Players Association (UNI Global Union, 2020). As a result of the growing recognition of human rights in sport, many international and national sports organisations have begun to integrate human and children’s rights into their policies and strategies. In 2018, for example, the International Olympic Committee (IOC) launched an Athletes’ Rights and Responsibilities Declaration (IOC, 2018), which was developed in collaboration with athletes and covers the rights and responsibilities of athletes, including topics such as anti-­doping, non-­discrimination, protection from harassment and abuse, and other human rights concerns. The Declaration sits alongside various other resources created by the IOC relating to the welfare and rights of athletes, such as the establishment in 2018 of the IOC Advisory Committee on Human Rights, which is chaired by a former UN commissioner for human rights and aims to assist the IOC in meeting its human rights responsibilities (Associated Press, 2018). Thus, while the IOC has received substantial (and often warranted) criticism in recent years for overlooking human rights, especially in relation to abuses committed by governments hosting Olympic and Paralympic Games (see Human Rights Watch, 2014; Watts, 2015), it does appear that wider societal recognition of human rights is beginning to filter through to the world’s most powerful sports organisation. Similarly, the principles of children’s rights underpin the policy framework for many national sports organisations in the United Kingdom. The NSPCC Sport England Child Protection in Sport Unit (CPSU), a leading government-­backed agency with responsibility for safeguarding and child protection in sport, incorporates the requirement for children to be listened to and respected as individuals into its set of professional standards (see CPSU, 2018; for more on this, see Lang & Hartill, 2015). Similarly, the International Safeguards for Children in Sport (International Safeguarding Children in Sport Working Group, 2014) take as their starting point the four guiding principles contained within the UNCRC. As such, the Standards’ fundamental principles are clearly aligned with human (and children’s) rights. For example: • • • • • •

All children have the right to participate, enjoy, and develop through sport, in a safe and inclusive environment, free from all forms of abuse, violence, neglect, and exploitation, Children have the right to have their voices heard and listened to, There are certain factors that leave some children more vulnerable to abuse, and steps need to be taken to address this, Children have a right to be involved in shaping safeguarding policy and practice, Organisations should always act in the best interests of the child, Everyone has the right to be treated with dignity and respect and not be discriminated against based on gender, race, age, ethnicity, ability, sexual orientation, beliefs, religious, or political affiliation. (International Safeguarding Children in Sport Working Group, 2014, p. 5) 19

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Concluding thoughts These and other developments in integrating human rights into sport have led Donnelly (2016, p. 107) to suggest that there is “so much recognition of players’ rights, and so much diverse action in an attempt to achieve them, that we may have reached a tipping point”. We can only hope that Donnelly’s optimism is well placed. It certainly seems as though there is now significant forward momentum, at least in some sport contexts, towards a more holistic approach to athlete welfare and an increasing demand that sports organisations explicitly recognise and respect athlete welfare and, increasingly, human rights as core parts of their business. Change often comes slowly to large institutions, so it is perhaps still too early to say whether Donnelly’s prediction is accurate and whether these developments will lead to a discursive shift in understandings of athlete welfare to include a broader range of issues than are currently often considered. However, there are hints that a change is underway. One example is the number of elite athletes starting to speak out publicly about unethical sports environments and their experiences of non-­sexual violence and abuse. In 2017, for example, British Olympic bobsleigh athlete Rebekah Wilson spoke out about how the intense pressure of training led to her to self harm, cutting her arms and legs and banging her head against a wall as a way of trying to cope (Roan, 2017). The same year, a Guardian newspaper joint investigation uncovered the ‘trade’ in athletes from parts of Africa to rich Arab and Middle Eastern countries wanting to make a mark on the international sporting stage – Ethiopian-­born middle-­distance athlete Lily Abdullayeva and Kenyan-­born distance runner Leonard Mucheru, who both switched allegiance from their birth countries to Azerbaijan and Bahrain, respectively, alleged financial abuse, being treated like “sporting slaves”, and being cast aside if they failed to produce results (Kelner, 2017). In 2018, former Australian World Number 4 tennis player Jelena Dokic revealed the beatings and emotional abuse and neglect she experienced throughout her career at the hands of her father (Dokic with Halloran, 2018). Later that year, British Olympic swimming medallist Michael Jamieson spoke out about being “addicted to training  .  .  .  [a]ddicted to being flat-­ out exhausted” and his “pride” at pushing himself so hard in training that he went into heart arrhythmia (McRae, 2018). Then, in 2019, track athlete Mary Cain prompted a string of fellow female athletes to come forward alleging physical and emotional abuse, including pressure to take diuretics and body shaming, by now-­disgraced coach Alberto Salazar in the Nike-­ sponsored Oregon Project (Cain, 2019; Futterman, 2019). Another indication of potential change is the number of scientific articles being published on a range of issues that can compromise athlete welfare and that use this term. A cursory search of the Sport Discus publications database, for example, showed that between 2000 and 2005, there were four scientific articles published that used the term ‘athlete welfare’. All focused on specific welfare-­related issues (concussion, sexual abuse), with half focusing specifically on sexual offending in sport. Between 2006 and 2010, the number of articles referring to the term ‘athlete welfare’ stood at 12, again all on specific issues (i.e. concussion, the impact of competition appraisals on athletes’ emotional well-­being). But by 2011–2015, this figure had rocketed to more than 100. A similar number had been published in the four years before the end of 2019. Not only are we seeing an increase in the amount of empirical work that is framed as relating to athlete welfare, but this work also covers a broader range of topics than ever before, including but also extending far beyond sexual violence and child protection concerns, as the chapters within this Handbook illustrate. This mainstreaming of athlete welfare, whether or not couched within a human rights agenda, is a welcome development. Whether this continues and whether these developments succeed in expanding understandings and recognition of a broad range of welfare issues cannot 20

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yet be known. If sport and all involved are to truly take the welfare of athletes and their duty of care to them seriously, everyone involved needs to adjust the focus to one that puts the athlete and their experiences first. Sport needs to take as its starting point the impact of violence and other negative experiences on athletes rather than focusing its prevention efforts predominantly on a particular type of violence. If sports organisations and policymakers adopt the impact on the athlete as the starting point, then a wider range of forms of violence and abuse that have significant negative affect on athletes’ welfare may well come to be better understood and managed. To this end, it’s vital that all sport stakeholders work hard to raise the profile of athlete welfare and the wide range of risks that can compromise this. At the very least, coaches, athletes, and parents need to be thoroughly informed of the prevalence of different welfare issues and the consequences of these for athletes, as well as how the culture of sport can perpetuate these issues. Equally, everyone in sport needs to speak up to challenge dominant discourses that prioritise certain forms of violence and marginalise other welfare issues. Sport has made great strides in recent years in accepting and tackling violence and exploitation in its ranks. But there is still a significant way to go before the full spectrum of behaviours that can jeopardise the welfare of (adult and child) athletes is acknowledged and thoroughly addressed. Achieving this will require concerted and ongoing efforts from everyone involved in sport and a commitment to putting athletes at the centre of sporting practices.

Note 1 A child is defined in the UNCRC as under the age of 18, unless the age of majority is attained earlier under national legislation.

References Associated Press (2018, December 1). Olympic host-­city contracts to include “human rights standards” starting in 2024. ESPN Online. Retrieved from: www.espn.com/olympics/story/_/id/25422960/ ioc-­sets-­human-­r ights-­advisory-­committee-­starting-­2024 Barreto, J.-­M. (2013). Human rights from a third world perspective: Critique, history and international law. Newcastle-­upon-­Tyne: Cambridge Scholars. Brackenridge, C. H. (1991). Cross-­gender coaching relationships in sport: Myth, drama or crisis? Coaching Focus, 16, 12–17. Brackenridge, C. H. (2001). Spoilsports: Understanding and preventing sexual exploitation in sport. London: Routledge. Brackenridge, C. H. (2004). Women and children first? Child abuse and child protection in sport. Sport in Society, 7(3), 322–337. Cain, M. (2019, November 7). I was the fastest girl in America, until I joined Nike. New York Times. Retrieved from: www.nytimes.com/2019/11/07/opinion/nike-­running-­mary-­cain.html Centre for Sport and Human Rights (2018b). Overview. Retrieved from: www.sporthumanrights.org/en/ about/overview Centre for Sport and Society (2009). Athlete bill of rights. Retrieved from: www.sportanddev.org/sites/ default/files/downloads/bill_of_rights.pdf Child Protection in Sport Unit (2018). Standards for safeguarding and protecting children in sport. Leicester: CPSU. Retrieved from: https://thecpsu.org.uk/media/445556/web_cpsustandards.pdf Child Rights International Network (2019). Declaration of the rights of the child. Retrieved from: https:// archive.crin.org/en/library/un-­regional-­documentation/declaration-­r ights-­child-­1923.html Council of Europe (1975). European sport for all charter. Retrieved from: www.europa.clio-­online.de/ Portals/_Europa/documents/B2016/Q_Scholl_Charter.pdf 21

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Council of Europe (1992a). Recommendation No. R (92) 13 Rev of the committee of ministers to member states on the revised European sports charter. Retrieved from: https://rm.coe.int/16804c9dbb Council of Europe (1992b). Code of sports ethics. Retrieved from: ttps://search.coe.int/cm/Pages/result_ details.aspx?ObjectID=09000016804cf400 Council of Europe (2000). Resolution on the prevention of sexual harassment and abuse of women, young people and children in sport. Retrieved from: www.coe.int/t/dg4/sport/resources/texts/spres00.3_en.asp Council of Europe (2007). Council of Europe convention on the protection of children against sexual exploitation and sexual abuse. Retrieved from: www.coe.int/en/web/conventions/full-­list/-­/conventions/ rms/0900001680084822 David, P. (2005). Human rights in youth sport: A critical review of children’s rights in competitive sports. New York: Routledge. Dokic, J. with Halloran, J. (2018). Unbreakable. London: Ebury Press. Donnelly, P. (2016). We are the game? Player democratisation and the reform of sport governance. In Vanden Auweele, Y., Cook, E. & Parry, J. (Eds.), Ethics and governance in sport: The future of sport reimagined (pp. 102–108). London: Routledge. EU Athletes (2009). EU Athletes – dedicated to protecting and promoting the interests of elite athletes. Retrieved from: https://euathletes.org/organisation/ European Commission (2014). Gender equality in sport: Proposal for strategic actions 2014–2020. Retrieved from: http://ec.europa.eu/assets/eac/sport/events/2013/documents/20131203-­gender/final-­proposal-­ 1802_en.pdf European Court of Human Rights/Council of Europe (2010). European convention on human rights. Strasbourg: Council of Europe. Retrieved from: www.echr.coe.int/Documents/Convention_ENG.pdf Futterman, M. (2019, November 14). Another of Alberto Salazar’s runners says he ridiculed her body for years. New York Times. Retrieved from: www.nytimes.com/2019/11/14/sports/olympics/alberto-­ salazar-­nike.html Human Rights Watch (2014, February 21). Russia: Sochi highlights need for Olympic reforms. Human Rights Watch. Retrieved from: www.hrw.org/news/2014/02/21/russia-­sochi-­highlights-­need-­olympic­reforms International Olympic Committee (2018). Athletes’ rights and responsibilities declaration. Retrieved from: https://d2g8uwgn11fzhj.cloudfront.net/wp-­content/uploads/2018/10/09134729/Athletes-­Rights-­ and-­Responsibilities-­Declaration_2018.10.07.pdf International Safeguarding Children in Sport Working Group (2014). International safeguards for children in sport. Retrieved from: https://downloads.unicef.org.uk/wp-­content/uploads/2014/10/International-­ Safeguards-­for-­Children-­in-­Sport-­version-­to-­view-­online.pdf Kalinski, M. (2017). State-­sponsored doping system in Russia: A grand failure of the largest institutional conspiracy in history of sport. Annals of Sports Medicine and Research, 4(4), 1116. Kayser, B., Mauron, A. & Miah, A. (2007). Current anti-­doping policy: A critical appraisal. BMC Medical Ethics, 8(2). doi:10.1186/1472-­6939-­8-­2 Kelner, M. (2017, August 3). “We are treated like sporting slaves”: Ethiopian lifts lid on trade in athletes. The Guardian. Retrieved from: www.theguardian.com/sport/2017/aug/03/sporting-­slaves-­ethiopian-­ trade-­athletes-­lily-­abdullayeva-­azerbaijan Kitzinger, J. (1997). Who are you kidding? Children, power and the struggle against sexual abuse. In James, A. & Prout, A. (Eds.), Constructing and reconstructing childhood: Contemporary issues in the sociological study of childhood (pp. 157–183). London: Routledge. Lang, M.  & Hartill, M. (2015). Safeguarding, child protection and abuse in sport: International perspectives in research, policy and practice. London: Routledge. Lang, M., Mergaert, L., Arnaut, C. & Vertommen, T. (2018). Gender-­based violence in EU sport policy: Overview and recommendations. Journal of Gender-­Based Violence, 2(1), 109–118. Lang, M. & Pinder, S. (2017). Telling (dangerous) stories: A narrative account of a youth coach’s experience of an unfounded allegation of child abuse. Qualitative Research in Sport, Exercise and Health, 9(1), 99–110. LeGates, M. (2001). In their time: A history of feminism in Western society. New York: Routledge. 22

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Lenskyj, H. H. (1990). Power and play: Gender and sexuality issues in sport and physical activity. International Review for the Sociology of Sport, 25, 235–245. Lenskyj, H. H. (1992). Unsafe at home base: Women’s experiences of sexual harassment in university sport and physical education. Women in Sport and Physical Activity Journal, 1(1), 19–34. McRae, D. (2018, January 29). Michael Jamieson: “Swimming has a problem. Micro-­dosing is a huge issue”. The Guardian. Retrieved from: www.theguardian.com/sport/2018/jan/29/michael-­jamieson-­ swimming-­depression-­doping-­micro-­dosing-­interview McVeigh, J. & Lang, M. (forthcoming). The politics of safeguarding and child protection in sport: A history of the present. In Wagg, S. & Pollock, A. (Eds.), The Palgrave handbook of sport, politics and harm. London: Palgrave Macmillan. Mergaert, L., Arnaut, C., Vertommen, T. & Lang, M. (2016). Study on gender-­based violence in sport in EU member state countries: Results of a study commissioned by the European commission education, audio-­visual and culture executive agency. Brussels: European Commission. Retrieved from: https://ec.europa.eu/sport/ sites/sport/files/gender-­based-­violence-­sport-­study-­2016_en.pdf Mitra, D. (2014). Human rights: From an alternative viewpoint. Procedia: Social and Behavioural Sciences, 157(27), 363–368. Nelson, B. J. (1986). Making an issue of child abuse: Agenda setting for social problems. Chicago, IL: University of Chicago Press. Office of the High Commissioner of Human Rights (2020). What are human rights? Retrieved from: www. ohchr.org/en/issues/pages/whatarehumanrights.aspx Rhind, D. J. A. & Owusu-­Sekyere, F. (2019). Evaluating the impacts of working towards the International Safeguards for Children in Sport. Sport Management Review. doi:10.1016/j.smr.2019.05.009 Roan, D. (2017, July 27). Rebekah Wilson: Ex-­GB Olympic bobsleigher says pressure led to self-­harm. BBC Sport. Retrieved from: www.bbc.co.uk/sport/winter-­sports/40738768 Sport and Rights Alliance (2015). What is the sport and rights alliance? Retrieved from: www.fanseurope. org/en/activities/die-­sport-­and-­r ights-­alliance.html UN Educational, Scientific and Cultural Organisation (2015). The international charter of physical education, physical activity and sport. Retrieved from: https://unesdoc.unesco.org/ark:/48223/pf0000235409 UN General Assembly (1989). United Nations convention on the rights of the child. Retrieved from: https:// downloads.unicef.org.uk/wp-­content/uploads/2016/08/unicef-­convention-­r ights-­child-­uncrc. pdf?_ga=2.94994202.763666590.1585745390-­1268871907.1585745390 Ungerleider, S. (2001). Faust’s gold: Inside the East German doping machine. New York: Thomas Dunne Books. UNI Global Union (2020). The World Players Association. Retrieved from: www.uniglobalunion.org/ sectors/world-­players/about United Nations (1948). General assembly resolution 217 A: Universal declaration of human rights. Retrieved from: www.ohchr.org/EN/UDHR/Documents/UDHR_Translations/eng.pdf Watts, J. (2015, December 8). Rio Olympics linked to widespread human rights violations, report reveals. The Guardian. Retrieved from: www.theguardian.com/world/2015/dec/08/rio-­olympics-­2016-­human­r ights-­violations-­report White, B. (1999). Defining the intolerable: Child work, global standards and cultural relativism. Childhood, 6(1), 133–144. World Players Association (2018). Declaration on safeguarding the rights of child athletes. Retrieved from: www. lawinsport.com/topics/news/item/world-­players-­association-­declaration-­on-­safeguarding-­the-­r ights-­ of-­child-­athletes

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2 Scientism and the welfare of athletes Minds, brains, genes and agency Leon Culbertson

Introduction One possible focus of attention in considering issues relating to the welfare of athletes is the things that are done to, or done by, athletes; another is the structures and systems within which those things are done; yet another is the ways of seeing things (pictures or conceptions), reasoning (‘logic’), values and ideologies that motivate or sustain the aforementioned practices, systems and structures. The focus of this chapter is the third of those sets of options. More precisely, it is concerned with some of the ways in which scientism – in some prominent views of the relationship between minds, brains and persons, and of the relationship between the body, genes and athletic performance – seems to contribute to the development and perpetuation of a conception of performance enhancement in sport that frequently seems to be to the detriment of the welfare of athletes. The conceptualisation of athletes as some kind of machine is a well-­established habit and may be thought by some to be harmless. It probably began with innocuous similes, such as ‘Your body is like an engine; it needs plenty of fuel!’ However, first the ‘like’ is dropped and the simile becomes a metaphor, and then it becomes hard to remember that it is a metaphor. That leads to metaphor-­laden interpretations of scientific research being employed to support pictures in which the metaphor is viewed as literally accurate when the relevant level of abstraction is claimed to be the ‘fundamental’ level of explanation. By then, as Wittgenstein (2009, §308) put it, “the decisive moment in the conjuring trick has been made, and it was the very one that seemed to us quite innocent”. In recent years, however, a sequel has emerged to that story. This chapter will consider the contribution of widespread cognitive scientism, which falls foul of what Bennett and Hacker (2003, pp. 68–107) call “the mereological fallacy”, to a view of the athlete that reduces agency, through the reduction of mental attributes, to neurological ‘activity’ (a metaphor) in the brain. The picture of the body of the athlete as a machine, and the picture of the mental attributes as fundamentally the result of the functioning of that machine, seem to fit together nicely, but each is like an Escher drawing, as is the result of combining the two. The athlete is the proper subject of admiration in sporting performance because the attributes to be admired are those properly ascribed to human beings, not to parts of human beings. 24

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The attributes worthy of admiration are those of the athlete in question, not parts of that athlete (or his or her support team). Performance enhancement by prohibited means detaches those means of bringing about victory from the subject of admiration on the achievement of victory (or records). If the prohibited means of performance enhancement were the thing that made the difference between winning and losing, or breaking a record and not breaking a record, then the athlete wouldn’t be a proper subject for admiration in relation to that particular victory or record any more than if he or she were wearing Hermes’s winged sandals or seven-­league boots. Such an observation underlines the fact that the enterprise shouldn’t be thought of as being about winning at any cost or by any means, but it also emphasises the fact that the reductionism evident in scientistic conceptions of the athlete not only paves the way for pictures, reasoning and values that might justify performance enhancement practices (prohibited or otherwise) that may be detrimental to the health and welfare of the athlete, but it creates conditions that render any apparent ‘achievement’ hollow, and the realisation of that should surely negatively affect the welfare of the individual person long beyond the point he or she ceases to be an athlete. This chapter will briefly outline the conception of the athlete as a machine before looking in more detail at the idea that it is not only capacity to perform tasks such as running, jumping and throwing (what are often called ‘physical tasks’) that can be understood by viewing the athlete as a machine, but mental attributes of the athlete can also be understood in those terms. The problems with those two mutually supporting pictures are then discussed, and the contribution of such ways of viewing the athlete to the detriment of athlete welfare is briefly considered.

The body, genes and athletic performance Sport and exercise science institutionalises abstractions in the way that we think about athletes. Those abstractions motivate various subdisciplines, such as sport and exercise biomechanics, sport and exercise physiology and sport and exercise nutrition. That is unsurprising, given that we know that a great many physiological factors contribute to sporting performance. Biomechanical considerations are not only of relevance in relation to performance itself but also in relation to the avoidance of injury, and it seems plausible to think that nutrition may have a positive bearing on performance if properly understood or, at least, that it can have a negative influence on performance if poorly understood. The motivations for such types of inquiry are perfectly well justified if one has the goal of enhancing athletic performance. However, such forms of inquiry also emphasise the tendency to view the athlete as if he or she were a machine. The emphasis in such areas of sport and exercise science is on making the body function better in relation to specified performance goals. There is a stimulus–response logic in operation, and the whole point is that the relationship between stimulus and response is measurable, consistent and predictable. Knowledge of such matters informs training and preparation and, so the story goes, improves performance. Of course, consideration of, for example, the track and field world records, very many of which are, at the time of writing, over 20 years old, might be thought to suggest that the case for the value of such enterprises is yet to be made. Nonetheless, regardless of whether the evidence supports the conclusion that sports science is of benefit to performance, elite athletes have embraced it, as have professional sports clubs. The issue here is not whether applied sports science does what it aspires to do (improve performance) but rather that even if it does, it contributes to the tendency to view athletes not as persons but as sophisticated organic machines. Physical forces on limbs and joints, power output, the functioning of cardio-­vascular systems and so on are measured, but the person (the agent) is irrelevant to that enterprise. 25

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There’s nothing wrong with that, given the goal of the enterprise (unless one objects to the goal), but it contributes to a way of viewing the athlete as a machine. There’s nothing scientistic about regarding the functioning of the cardio-­vascular system or the measurement of forces on the knee during the triple jump as matters for science. Scientism comes in various forms, but the one that is of concern here is that which regards the forms of investigation and explanation of the natural sciences to be appropriate or either the best or the only legitimate forms of investigation and explanation in areas outside the natural sciences. The concern in relation to performance enhancement in sport cannot, therefore, be a concern over scientific investigation of the physiology of athletes or the biomechanics of specific movements in sport. There’s nothing scientistic about sports science, properly understood. Rather, it is the picture of the athlete as some kind of machine, and the reasoning and actions that follow from being gripped by that picture, that display a form of scientism that consists of treating the athlete like a machine and believing that getting the science right is all that there is to the development of the athlete because that will bring the best possible performance, and, after all, that is what it is all about. So an athlete that performs well is a happy and flourishing athlete. That way of seeing things is scientistic because it loses the normativity of concepts relevant to human beings and, in doing so, fails to appreciate that sporting performance is a specifically human achievement. In action, including actions in sport, human beings, as agents, make judgements and decisions. They act for reasons, which can be evaluated publicly by others. The actions that are taken can be considered good, bad or indifferent, according to public criteria. There are norms within practices, and the things that athletes do, if they are to be considered appropriately, should be considered in relation to the relevant norms on any occasion under consideration, which will not solely be norms specific to the given sport – athletes are never not human beings and members of a wider society and a wider culture, as opposed to a particular sporting subculture. Those are important considerations in the appreciation of sporting performance.1 If athletes really were machines, then there would be nothing to admire in sport; it is precisely the fact that athletes are human beings, with all the vulnerabilities and failings that involves, that makes them proper subjects for admiration wherever such admiration in sport is appropriate. What is to be admired isn’t simply that the athlete performed well and won but that he or she did so despite all the worries and pressures that accompany competition, despite the fact that others were doing everything they could to win, and so victory required good judgements and a good temperament. There’s something to be admired in the fact that the athlete trained hard and didn’t succumb to the temptation to skip training when the weather was bad or when things weren’t going so well. There may be something to admire in the fact that athletes are prepared to make sacrifices, although we might sometimes think that the specific sacrifices that some athletes make demonstrate precisely the myopic, self-­centred, self-­absorbed, self-­seeking, self-­ interested, selfish, narcissistic and vain attitudes that are a feared consequence of the scientistic picture of the athlete. In other words, part of the worry here is that athletes can, in a sense, be their own worst enemy in this regard, but surely not without being acculturated into the values and practices that are both a consequence of, and perpetuate the dominance of, a scientistic picture of the athlete. A feature of such scientism is the idea that our genes make us what we are. That is not only inaccurate, but it encourages a view of human beings as worthy only of the value they appear to have. In other words, it encourages us to rush to judgement in relation to the value of others because it encourages a form of determinism in which what someone seems to be, and what that person seems to be capable or incapable of, at present, is bound up with what they

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are, which is, in turn, bound up with their genetics. As with other forms of scientism, such a view misunderstands both the science here and the relevant concepts. If we think that genes are all there is to performance, then treating athletes as laboratory specimens, and performance enhancement as something that must develop by exploring genetic enhancement (Culbertson, 2009; Miah, 2004; Tamburrini  & Tännsjö, 2005), is to de-­humanise athletes in at least one sense, namely that which tries to account for the abilities, thoughts, actions and so on of human beings in non-­normative (largely nomological) terms.2

The mechanical mind: computation and thought So much for one strand of the dominant picture – that which focuses on the abstraction of a particular notion of ‘the body’ and conceives of the body as being like a machine, proper maintenance of which will produce maximal performance. What about the other strand in the dominant picture, namely the mechanical view of the mind? The move from behaviourism to cognitivism as the dominant tradition in psychology has its proximate3 roots in developments in the mid-­1950s and through the 1960s. The development of central state materialism conflated so-­called ‘mental states’ with brain states, such that they were taken to be literally the same thing (a position known as the identity theory of the mind). ‘Functionalism’ developed from the observation that mental states are multiply realisable in the sense that creatures with different neurology and wider physiology can, for example, experience pain (and the point is supposed to generalise to other mental attributes). As a consequence, the ascription of a mental attribute cannot simply be the identification of a particular brain state. Functionalism is the view that mental concepts identify the different functions of mental states and processes or the causal roles that such states and processes have. Functionalism flourished in the development of the computational theory of mind. The computational theory of mind, in its classic form, is, in the most general sense, the view that the mind works like a computer. On the model of classic computation, what that means is that the brain manipulates symbols (in the form of neuronal firing and non-­firing) on the basis of the form of those symbols (the so-­called ‘syntactic properties’ of the symbols) in accordance with algorithms (formal rules), such that the output is consistent with those symbols having been manipulated in accordance with their meaning (their semantic properties). The representational capacities of such symbols make it possible, so the theory goes, for us to have what is known as ‘intentional mental states with content’, in other words, thoughts, beliefs, desires and so on that are about things in the world. The computational theory of mind dominated through most of the 1970s and 1980s, but by the 1990s, an alternative ‘computational architecture’ was being taken to offer a rival (or, in some cases, broadly complementary) model for understanding the mind, and this model was itself based on human neurology. That newer form of computational theory of mind is known as ‘connectionism’, and it is claimed that there are many mental attributes that it models far better than classic computation. These are not only landmarks in the recent development of psychology but also milestones in the emergence of the multidisciplinary (although often mistakenly called ‘inter-­disciplinary’) enterprise of cognitive science. Regardless of what we make of the details of the respective specific claims, these developments have had a very powerful influence on both the popular and the professional understanding of the mind. That is not to say that such developments have been beneficial – quite the opposite; they have been deeply misleading – but it is to recognise their very significant influence and the central contribution they have made to the dominant picture of the human being and, a fortiori, the athlete, as a sophisticated machine.

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Minds, brains and persons: cognitive scientism and the mereological fallacy Someone might think that, on the basis of what has been argued here thus far, all that has been shown is that there is now a well-­established tradition of thinking of human psychological attributes as reducible in some way or other to biology and neurology. There may have been various specific theories proposed, and each may have proved unsatisfactory to some while persuading others, but why should we think that the whole project is misconceived? There are a great many reasons, but space will only permit consideration of one of those reasons here, namely the fact that such an approach falls victim to what Bennett and Hacker (2003, pp. 68–107) call “the mereological fallacy”. The concern here is that the ascription of psychological attributes to the body, or to parts of the body (the brain, collections of neurons etc.), results in statements that literally have no sense (i.e. are meaningless). Mereology is the study of the relationship between parts and wholes, and so the mereological fallacy has been given that name because it fails to recognise that the ascription of psychological predicates should be to the human being, not to parts of the human being, such as the brain, regions of the brain, or particular collections of neurons. Bennett and Hacker (2008, p. 244) emphasise that, “[t]o speak of my body is to speak of the corporeal features of the human being that I am”. Such corporeal features include my appearance, my sensations, and the state of my body, such as whether it is fit or healthy, is injured and so on. Bennett and Hacker (2008, p. 244) also emphasise, however, that: Knowing, perceiving, thinking, imagining, etc. are not corporeal features of human beings and are not ascribable to the body a human being has, any more than they are ascribable to the brain that a human being has. Human beings are not their bodies. Nevertheless, they are bodies, in the quite different sense of being a particular kind of sentient spatio-­temporal continuant – homo sapiens; and the brain is a part of the living human being, as are the limbs. It is not, however, a conscious, thinking, perceiving part – and nor is any other part of a human being. For these are attributes of the human being as a whole. An obvious objection here is to think that this is just a case of dogmatic assertion based on preferences of linguistic style or an attempt to establish a conclusion by fiat. To think that, however, would be to be mistaken. On the contrary, they are observations about the conceptual, and therefore logical, interconnections within conceptual schemes around the use of certain words. Our logic, the application of our concepts, and our use of words in human interactions on specific occasions in particular contexts, are all normative matters in the sense that for it to be appropriate to say of someone that they possess the relevant concepts, they must be able to recognise logical inconsistencies in uses of words and also to recognise inferences that contravene the rules for the use of given words. The relevant rules are, in one sense, more like the rules of etiquette in a given social group than they are like the rules of a sport. Importantly, confusion in relation to such matters can lead to a failure to say anything meaningful at all. Attempts to ascribe psychological predicates to the brain are not false but rather meaningless; they make no sense at all. Bennett and Hacker (2003, p. 78) stress, however, that such an observation: does not mean that they are silly or stupid. It means that no sense has been assigned to such forms of words, and that, accordingly, they say nothing at all, even though it looks as if they do. 28

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Specifically, it is the uses of the sentences that are taken to articulate the relevant thought that have no sense, which means that those utterances cannot be evaluated as true or false because a statement can only be evaluated as true or false if it makes sense (cf. Bennett & Hacker, 2008, p. 238). In cases of the mereological fallacy, there is nothing that is said to be the case because there is nothing there could be which those words, used in that way, say things to be. If we have no idea what it would be for something to be true, then we cannot say that it is false, but rather we must regard it as meaningless; for a statement to be meaningless is quite different from it being false. We don’t know what it would be for the brain to think, know, reason, see and so on, so we have no basis for saying that any such claims are false because there are no logical consequences to such claims (nothing that follows from them), if saying such things is supposed to use the relevant words in ways for which there are established uses. Someone might think that our not knowing what it would be for a brain to be the bearer of psychological attributes is simply the result of a lack of empirical knowledge, which could be rectified at some point in the future. However, that is confused; it is not an empirical matter at all – no future research will tell us what we, at present, do not know in this regard. Rather, the point is that, given what it is to say, in our current use of the terms, ‘brain’, ‘think’, ‘know’, ‘reason’, ‘see’, ‘human being’ and so on, and what we normally say in ascribing thought, knowledge, reasoning, seeing and so on, there is nothing that it could be for a brain to think, know, reason or see. We could, of course, use the terms differently, but, as Hacker (2007, p. 279) emphasises, we could do that only if, “we changed a great deal of the surrounding grammar”, and if we did that, then, “the words would no longer mean the same”. Various defences have been offered in response to the claim that neuroscientists fall victim to the mereological fallacy. It is sometimes argued that, in the relevant cases, psychological predicates are being used as homonyms of ordinary psychological predicates and therefore have a different, technical meaning. It is also sometimes claimed that the meaning of ordinary psychological terms is being extended by analogy or that the ascription of psychological attributes to the brain is figurative or metaphorical. All of these attempts to excuse such talk fail for the same reason, namely that the inferences that are drawn by those who make such statements are consistent with the ordinary uses of the relevant terms. If they really were homonyms, analogies or metaphors, the inferential possibilities would be different from those of conventional use. As Bennett and Hacker (2003, p. 75) put the matter: the psychological expressions they use are being invoked in their customary sense, otherwise the neuroscientists would not draw the inferences from them which they draw. The inferences drawn show that the logical interconnections between the various concepts are taken to be the same as those that obtain in relation to our everyday uses.4

Enhancement, agency and responsibility: The dominant picture and athlete welfare The dominance of scientism has significantly contributed to creating the conditions for the development and growth of practices and attitudes that are frequently to the detriment of the physical and mental welfare of athletes.5 As described previously, the dominant, scientistic picture of human beings has two elements that are of particular importance in relation to athletes: 1 2

The body is viewed as some kind of sophisticated machine, The mind is viewed as some kind of computer or network of computers. 29

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In considering the different but relevant case of philosophical puzzlement, Wittgenstein (2009, §115) drew attention to the way pictures can lead us into confusion and hold us there when he said that: [a] picture held us captive. And we couldn’t get outside it, for it lay in our language, and language seemed only to repeat it to us inexorably. Baker (2004, p. 185, emphasis in the original) elaborates this observation when he stresses that: [a]s long as pictures or analogies are unconscious, we cannot be critical of, or even on our guard against, their influence. They exert tyranny over our thinking; they hold us in thrall; they produce mental cramps; in short, they restrict our freedom of intellectual movement – even though we are unaware of this. . . . As long as they are unconscious, pictures can never be put to the test; hence, in effect, they function as norms of representation just because they are not open to challenge. They seem to fix how things must be, or how they cannot be. Hence they exclude possibilities. In this respect they are comparable to prejudices . . . , superstitions . . . , or dogmas. Bringing the dominant picture to our attention, therefore, introduces the possibility of critically reflecting on it and the inferences it motivates. In a sense, the dominant picture is not, in itself, the problem; it is just a picture, and, as such, it is, in an important sense, neither right nor wrong, correct nor incorrect (Baker, 2004, p. 177, n. 50 and p. 262; Frege, 1977, p. 3); it is only in use that a picture can be thought of in such ways. Rather, it is the inferences that the picture encourages and supports that are the problem and also, perhaps, the uses to which the picture is often put. In the case of athletes, the first of the two aspects of the dominant picture contributes to a view of performance enhancement as akin to finding ways to make a car perform better – tuning the engine, changing components, using alternative fuel, altering aerodynamics and so on. That picture encourages extreme diets and supplementation (consider, for example, the use of sodium bicarbonate to enhance performance, despite the fact that it induces vomiting in many people), extreme training (which changes the body), doping, blood doping, ice baths, altitude training (which often involves travel, time away from family etc.), and heavy reliance on sports science. The picture of an athlete as a machine is just a picture, but when it shapes how we see the goals of elite sport and motivates inferences about how to achieve those goals such that the goal is taken, for example, to be enhanced performance, regardless of the means by which it is achieved, the conditions for detriment to the welfare of athletes are established. The key thing here is that detriment to athlete welfare in no way maps neatly onto the distinction between prohibited and permitted (legal and illegal) forms of performance enhancement, so even the goal of enhanced performance by any means within the rules does not preclude conditions detrimental to athlete welfare. On the contrary, it encourages such conditions. The various arguments for the thought that there is frequently little or no value to illegally enhanced performance are familiar.6 But legally enhanced performance is often of no real value (not the proper basis of admiration) either. If the sodium bicarbonate improves your 800-­metre time by two seconds, the most you can be admired for is having a strong stomach! The realisation of the emptiness of such performance enhancement is surely to the detriment of the welfare of the athlete/former athlete. What was the point of it all if nothing of value was achieved and you have to live the rest of your life knowing you won because of something you ingested? The logic of elite competitive sport is flawed. What is tested, judged and valued in such a logic? It’s often not the attributes of persons – not, in one sense, human attributes (there can in 30

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this sense be attributes of individual human beings that aren’t human attributes). If I run faster than everyone else but only because I took sodium bicarbonate, then I’m not a proper subject of admiration. If it wasn’t my training, dedication, hard work and so on that made the difference (things that are human attributes) then, in a sense, it isn’t me who should be admired or praised at all. It isn’t whether something is legal or not that matters, but whether it made the difference or the person did. If the value of the person’s achievement is tied up with the possibility of appropriate appreciation of the person’s abilities, then nothing other than the person’s actions can have made the difference to the achievement. The second aspect of the dominant picture contributes to a stimulus–response view of the mental, with an extremely narrow conception of what is of value and what is a priority. It doesn’t capture the complexity or the nature of human psychology. Conflation of the mind and the brain, and resulting ‘neuromania’, in which neuroscience is taken to explain everything and anything, simply couldn’t do the job envisioned for it here because it cannot capture the normativity of mental concepts. That has implications for the character of athletes and athletes’ values because failing to grasp the normativity of mental concepts is one way to fail to see human beings as human beings. That is not only to the detriment of the welfare of athletes, especially in later life, but also to the detriment of the welfare of everyone else. What is good for, in the interest of, or to the detriment of the welfare of the athlete is not necessarily what the athlete thinks it is. Accurate assessment of ‘welfare’ is not something to which one has privileged access in making judgements relating to oneself. There are two general senses of each of the relevant terms here, and confusion can arise if we do not recognise the differences. Something can be in my interest because it is what I want, but the same thing can, in another sense of the expression ‘in my interest’, not be in my interest because it will do me harm. It is in an alcoholic’s interest to acquire alcohol in the first sense of the term ‘interest’ but not in the second sense. A similar distinction can be made in relation to ‘detriment’ – someone might take something to be detrimental to her if it is something she doesn’t want to happen (it’s not in her interest in the first sense), but it may not be detrimental to her in the sense of doing her any harm, and it may even be in her interest in the second sense. The distinction also has forms in relation to ‘welfare’ and ‘good for’. What is good for one may not be what one thinks is good for one. There are public judgements, against public criteria, that can be made about someone’s welfare. In short, sometimes others know better, but whether they do is a public matter, not something dependent on the will on any individual. While it is necessary, in making judgements about sporting practices, to understand the contextual considerations relevant to the practice, that does not make such practices immune to informed public criticism on the basis of, among other things, context-­sensitive judgements against public criteria relating to athlete welfare.

Notes 1 See McFee (2018) for a related and fully developed argument in relation to the appreciation of dance – cf. particularly pp. xvi–xix. 2 I have identified other uses of ‘de-­humanise’ in Culbertson, 2007. 3 The search for something we might think of as a distal cause is ill conceived, both in seeking a cause in any strict sense and in the thought that it is possible to identify any clear ultimate origin of such developments. Nonetheless, there is clearly a wider history to the emergence of cognitivism, such that it might be thought of as something of a re-­emergence (see Hacker, 2001, pp. 49–54). 4 Bennett and Hacker (2003, p. 74) also stress that, “[t]he final authority in the matter is [one’s] own reasoning. We must look at the consequences [one] draws from [one’s] words – and it is [one’s] inferences that will show whether [one] was using the predicate in a new sense or misusing it. If [one] is to be condemned, it must be out of [one’s] own mouth”. 31

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5 No sharp general distinction between the physical and the mental is implied here; what is physical detriment and what is mental detriment is an occasion-­sensitive matter, dependent on our concern in asking about which applies (if not both) in a given case. 6 I have argued elsewhere (Culbertson, 2012, pp. 204–205) that the case of the Scottish skier Alain Baxter at the 2002 Winter Olympic Games is not one of valueless performance, despite the fact that it is a case of an illegal performance, although central to that argument was the fact that although Baxter’s sample contained a prohibited substance, it was agreed that it was not performance enhancing.

References Baker, G. P. (2004). Wittgenstein’s method: Neglected aspects. Oxford: Blackwell. Bennett, M. R. & Hacker, P. M. S. (2003). Philosophical foundations of neuroscience. Oxford: Blackwell. Bennett, M. R. & Hacker, P. M. S. (2008). History of cognitive neuroscience. Oxford: Wiley-­Blackwell. Culbertson, L. (2007). Human-­ness, dehumanisation and performance enhancement. Sport, Ethics and Philosophy, 1(2), 195–217. Culbertson, L. (2009). Genetic enhancement in the dark. Journal of the Philosophy of Sport, 36(2), 140–151. Culbertson, L. (2012). Pandora logic: Rules, moral judgement and the fundamental principles of Olympism. Sport, Ethics and Philosophy, 6(2), 195–210. Frege, G. (1977). Logical investigations. Oxford: Blackwell. Hacker, P. M. S. (2001). Wittgenstein and the autonomy of humanistic understanding. In Allen, R. & Turvey, M. (Eds.), Wittgenstein, theory and the arts (pp. 39–74). London: Routledge. Hacker, P. M. S. (2007). Human nature: The categorial framework. Oxford: Blackwell. McFee, G. (2018). Dance and the philosophy of action: A framework for the aesthetics of dance. Binsted: Dance Books. Miah, A. (2004). Genetically modified athletes: Biomedical ethics, gene doping and sport. London: Routledge. Tamburrini, C.  & Tännsjö, T. (Eds.). (2005). Genetic technology and sport: Ethical questions. London: Routledge. Wittgenstein, L. (2009). Philosophical investigations (4th rev. ed.) (Trans. G. E. M. Anscombe, P. M. S. Hacker & J. Schulte). Oxford: Wiley-­Blackwell.

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3 Organisational obligations toward athlete transitions Confronting the bureaucratisation of athlete welfare with an ethics of care G. Z. Kohe and L. G. Purdy

Introduction Research on career transitions in sport has been an area of scholarly interest for several decades, with work focusing on athletes’ transitions out of sport and the various types of transitions that occur within/across sport and levels (Stambulova, Alfermann, Statler  & Côté, 2009). Such investigations have highlighted the importance of transitions within athletes’ lives and drawn attention to the complexities that some transitions pose to individuals’ daily lives and experiences. While key features of athletes’ transitions within and beyond sport have been identified, transitions appear to be highly subjective. From a welfare perspective, athlete transition periods may precipitate several issues. These include the uncertainty of employment and a possible change in lifestyle; feelings of vulnerability due to athletes having expectations, goals, and plans change; possible fear of the unknown, which may be problematic for athletes whose lives/ careers are built around structure and organisation; and the concern that transitions may have consequences beyond the individual athlete to their wider support networks/entourages. Recently, high-­profile athletes who have spoken out about difficulties in the transition process have placed pressure on sport organisations to better support athletes during and after key transition points. Calls for organisational acknowledgement of athlete transitions are underpinned by explicit or latent concerns regarding welfare. Within this, prevailing discourses have developed around the assumed implications transitions have on athletes’ welfare and, by extension, what the organisational responses need to/must be. This chapter considers some of the links and issues between athlete transition programmes and wider welfare issues that are engendered within elite sport. Our interest is not in the utility, or otherwise, of the specific programmes themselves but rather in the ways in which such programmes are indicative of cultural shifts within the industry (i.e. regarding sports workers’ expectations and corresponding organisational obligations about welfare). To begin, we articulate key themes within the athlete transition literature. We then situate transitions within a context of welfare provision. Before introducing a theoretical framework of care ethics, we discuss two sports organisations’ approaches to athletes’ transitions that highlight care concerns. 33

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Scholars examining sport transitions have identified a number of key aspects of athletes’ transition experiences (i.e. athletic identity; voluntary control over the decision to retire; the type, quality, and significance of the transition process; and distinctions between within-­sport and out-­of-­sport career movements) (Butt & Molnar, 2009; Pearson & Petitpas, 1990; Warriner & Lavallee, 2008). One area of early interest has been in the development of models to help explain and map career transitions and provide directions for future research (i.e. Stambulova, 2003; Taylor & Ogilvie, 1994; Wylleman, Alfermann & Lavallee, 2004). This work has been of value in providing frameworks that articulate some of the characteristics of athletes’ career experiences, the interconnectedness between different areas of athletes’ lives, and possibilities that exist potentially for smoothing the transition process. In addition, these models also provide a common ground upon which collective understandings of transitions might be entertained. However, issues of subjectivity and relativity remain. Scholarly work has differentiated that transitions can be characterised as normative or non-­ normative. A normative transition is one in which an athlete leaves one life stage and enters another, for example, moving from junior to senior level or from participation to retirement (Wylleman  & Lavallee, 2004). In contrast, a non-­normative transition is unpredicted, unanticipated, and involuntary, for example, contract termination, career/season-­ending injury, or personal issues that impact the sporting career (Schlossberg, 1981). Unsurprisingly, there has been significant recognition of the negative effects of transitions on athlete’s lives, for example, adverse effects on mental health, social exclusion and/or withdrawal, occupational and financial woes, personal and professional identity crises, and changes to life satisfaction (Dimoula, Torregrosa, Psychountaki & Gonzalez Fernandez, 2013; Erpič, Wylleman & Zupančič, 2004; Martin, Fogarty & Albion, 2014; Perna, Ahlgren & Zaichkowsky, 1999). Recent work here has articulated the increased need for athletes (and coaches and sport organisations within the sector) to consider the complexities of transitions/retirement and to plan accordingly (i.e. Dimoula et al., 2013; Stambulova, Stephan & Jäphag, 2007). Part of this planning involves the identification of coping strategies which, when introduced to athletes, may ease the transition process (i.e. Alfermann, Stambulova & Zemaityte, 2004; Dimoula et al., 2013). Towards this end, Stambulova and colleagues (2007) identified how transition experiences might be mediated and, where adverse effects are concerned, mitigated using psychological training programmes. With regard to programme development, these have predominantly been based on the assumption that structured interventions are effective mechanisms that may help athletes identify, respond to, plan, and implement appropriate transition strategies that might afford them more positive experiences and alleviate detrimental consequences (Knights, Sherry & Ruddock-­Hudson, 2016). The ethos underpinning transition programmes has, to a large extent, positioned transitions as life-­altering and potentially negative and traumatic periods that require personalised responses. Furthermore, attention has been drawn to the need for sport organisations to do more to ease transitions over the course of athletes’ lives (Stambulova, Franck & Weibull, 2012). Reflecting academic concerns and wider sport-­sector discourses vis-­à-­vis athlete welfare, many sport organisations have been undertaking work to ensure that athletes are ‘appropriately’ equipped for lives and careers once elite-­level roles in the industry finish. In addition to external union-­based activities, sport organisations, such as the International Olympic Committee (IOC) and various national Olympic committees (NOCs) and international federations, now have educational programmes, business mentorship schemes, industry network opportunities, and personal support services designed to provide opportunities, encourage skill development, and alleviate feelings of uncertainty. In many cases, sport organisations’ efforts are highly laudable; indeed, the range of schemes and support available now offer a rich resource that may 34

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afford athletes a degree of comfort and security. However worthy, sport organisations’ efforts appear, in part, to have also been driven by contextual forces and cultural shifts that have raised industry expectations regarding how businesses operate for the betterment of their employees and improve ‘good’ governance.

Locating athlete transitions in a sociocultural-­political context Although sport organisations in many countries have been confronted with growing concerns about athlete welfare, institutional and organisational responses have differed considerably. In the United Kingdom, for example, athlete welfare issues have become subsumed within broader scrutiny of the sport sector and organisational accountabilities therein. One most recent development in this regard was the commissioning of an ‘independent’ report into sport organisations’ duty of care to their constituents (i.e. the Duty of Care in Sport Review [DOCSR]; Grey-­Thompson, 2017), led by House of Lords member and former Paralympian Baroness Tanni Grey-­Thompson. Focusing on athletes’ working lives and relations with governing bodies, the report covers: education; transitions; representation; equality, diversity, and inclusion; safeguarding; mental welfare; safety, injury and medical issues; and, last, recommendations. In essence, the report formalises the UK government’s concern for athlete welfare and, in doing so, places responsibility upon the government and organisations to improve institutional structures and cultures to enhance the athlete’s environment and organisational practices. What this review demonstrates is there are key points at which care in sport is needed more (i.e. safeguarding, mental health, youth talent identification, deselection, and transition junctures). The following section extends beyond athlete transitions to look more critically at the DOCSR and the way in which broader discussions about athlete welfare, and specifically athlete transitions, are situated therein (i.e. sports workers’ expectations and corresponding organisational obligations about welfare). The DOCSR highlights some of the fundamental care and welfare issues at play within the nation’s sport industry. Yet the report also speaks to prevailing concerns about care, labour, and employment beyond sport spaces. In the first instance, the report provides an overview of  the scope of current welfare programmes evident within the UK professional sport sector and the perceived gaps in provision based on engagement with an array of industry stakeholders. The report derives from a consultation undertaken with an independent working group of eight people who have various engagement in sport in the United Kingdom as well as a substantial number of sport sector stakeholders. This ‘consultation’ was compiled into a government configuration of welfare and a set of priorities for the sector going forward. While the report represents a standard component of policymaking processes, by attempting to address mass concerns and be universally applicable, the report offers no alternative presentation (essentially, for instance, it establishes a set of relatively inflexible criteria, expectations, and imperatives that most suit the government’s existing regulatory and governance frameworks). Here, while not (yet) legally enforced, the recommendations are designed to be set against existing funding provision, and thus organisations that do not appear to comply with the recommendations run the risk of losing future financial support. Beyond the funding consequences, there are more fundamental issues at play. The report does not, in the first instance, fully recognise the extant provisions with regard to welfare, care, support, and specifically transitions (i.e. formally established programmes, wider academic debates, and research about what works and what doesn’t) and furthermore does not present an evaluation/data of the ‘success’/’value’ of existing programmes. Although there may be possibilities for organisations to engage with the recommendations on their own terms, there is still a broad sweeping ethos that the issues contained within will be 35

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of relevance to all organisations. Out of this assumption about a shared experience comes the related assumption about an obligation to care and demonstrate a commitment to this version of welfare. In so doing, the DOCSR does not necessarily recognise the historical and evolutionary trajectories that some sport organisations have been on with respect to local, regional, and/or national development, resourcing, and capacity or, for that matter, existing inequalities that may inhibit care capacities. Finally, the burden/responsibility appears to be placed on the organisation, with far less emphasis on athletes’ and/or other sport constituents’ responsibilities. Congruent with the State’s funding of the sector, the DOCSR closely links organisational adherence and compliance to performance funding accountability measures. There is recognition that some of the recommendations will have implications for organisations’ resources, yet, in lieu of the government being forthcoming with funding, the expectation is that organisations will have to prioritise; the paradox created is that if organisations do not have the capacity to meet imperatives, there may be funding implications. Organisations provide athletes with opportunities, assistance, and resources in training and performance. However, there is a limit to some organisations’ resources to extend beyond the ‘fundamental’ aspects of performance (i.e. to include transitions to retirement, life skills training). This may be the case with state-­funded national federations and clubs, whereby performance funding mechanisms are outcome based and remain subject to strict monitoring and evaluation criteria. In many cases, the direct agendas of the organisation may relate to the maintenance of their high-­performance programmes in this first instance and then to subsidiary activities (for example, youth development, community outreach, and corporate social responsibility agendas – all of which are aimed at indirectly aiding the organisation in some way). The resource capacity of organisations to contribute to work and initiatives beyond these considerations may be a challenge due to financial constraints and/or limited due to organisational priorities. For example, in non-­Western contexts, organisations may have limited or no capacity for the type and standard of welfare provision that have come to be expected in the United Kingdom and other Western nations. The normal recourse for these sport organisations is to defer welfare support to the international federation initiatives, athlete unions, and/or organisations such as the IOC. The point here is to respect that welfare concerns and responsibilities have expanded to include a wide variety of issues, duties, and contexts that sport organisations are now being asked to confront. We acknowledge that there are connections between wider discussions of welfare in sport and, of note, specific welfare practices such as safeguarding and child protection which are legal requirements of sport organisations in the United Kingdom. This may be the case with state-­funded national federations and clubs, whereby performance funding mechanisms are outcome based and remain subject to strict monitoring and evaluation criteria. In many cases, the direct agendas of the organisation may relate to the maintenance of their high-­performance programmes in this first instance and then to subsidiary activities (for example, youth development, community outreach, and corporate social responsibility agendas – all of which are aimed at indirectly aiding the organisation in some way). Regardless, the DOCSR sets forth a clear State-­driven agenda for sector change. A few aspects of the DOCSR that illustrate organisational burdens and responsibilities are worth detailing. In the first instance, the review calls on the government to implement infrastructure changes – the most notable includes establishing a commission that would create clear industry standards and benchmarks related to care provision, build communication and pastoral support pathways (including a focus on athlete transitions), revise legislation, and improve stakeholder representation and participation (Grey-­Thompson, 2017). The report also calls on sports organisations to forge better relations with those involved in sport at all levels and ensure greater support throughout individuals’ sport experiences (Grey-­Thompson, 2017). 36

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The DOCSR provides an attempt at a comprehensive solution that appeals to a wide array of stakeholders and best reflects the diversity of welfare issues evidenced within and across the sector. In so doing, the review has essentially created a range of key delivery areas and imperatives to be addressed. While there is some overlap between items, the issue with such compartmentalisation is that it constructs a formal relationship between the objectives, delivery, measurement, and evaluation. Some national governing bodies of sport (NGBs) have engaged in the consultation process informing the report, and it is likely that NGBs see the report, the issues, and the priorities and processes it highlights as important. Yet there remains a danger that some NGBs reading the report approach ‘welfare’ as a tick-­box exercise to ensure the continuation of funding. Although not ideal, given the context in which NGBs face increased pressures to deliver a wider array of services and products to their constituents (and thus may make delivery decisions based on their own economies, efficiencies, and resources), a tick-­box mentality makes some sense. Further concerns here relate to communication, perception, and practice. For example, little is yet known about the report’s dissemination, reception, and the mechanisms needed to enhance and maximise engagement among NGBs and stakeholders. In addition, it is unclear as to how NGBs may receive, interpret, and implement the report’s recommendations. Given the DOCSR’s universality, there is also a possibility that NGB congruence and adherence may be lost, or at least diminished, as organisations engage with the report on their own terms and respond to the recommendations that most appropriately reflect their resources, vision, and capacity (Girginov, 2017; Shilbury & Ferkins, 2011; Tacon & Walters, 2016). Finally, the use of such directives neglects to recognise the work that some NGBs might already be doing or have done in relation to athlete welfare. Although the report has positioned care and welfare in measurable ways, conceptually, it is worth considering how care might be defined, understood, and operationalised within sport. Much as the report indicates, care is recognised as a key component of sport culture. Within this, athlete transitions are crafted as a key time in which organisations need to demonstrate care in situ. Accordingly, it is useful to think about the cultural structures and assumptions upon which this provision of care may be based and the implications this might have for NGBs in addressing duties, obligations, and expectations regarding athlete transitions. To summarise, the DOCSR review is one example of an institutional response to global sport welfare discourse. Within the United Kingdom, the review shows the potential roles and responsibilities stakeholders may take/need to take in addressing welfare and care provision complexities. The review recognises that transitions are a time of insecurity and emotional vulnerability and uncertainty. While athletes may require care at all points of their careers, transitions are periods in which there may be heightened emotions and vulnerability. Ergo, there may exist a perception that organisations should care more or that care should be more evident in relations with athletes. Demonstrations of care may be seen as an effective means to resolve emotional turmoil. Yet, and to rehearse earlier arguments about organisational burdens, it is important to recognise athlete transition care exists within a broad remit of organisational welfare and care provision. Thus, it is useful at this juncture to raise further questions about care, its place within organisational cultures, and also the underlying ethical dimension of care (which in sport is underpinned by assumptions vis-­à-­vis the sport ethic, fraternity, nostalgia, legacy, and stewardship).

Understanding a care ethic within welfare provision Within critiques of sport organisational welfare, discussions have not yet attended to care ethics as a constituent of provision. Focus has, rather, been on examining the underlying intentions of initiatives and the practicalities of their contents (Dimoula et al., 2013; Stambulova et al., 37

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2007). Nonetheless, a concern for care ethics (evident in other sectors such as health, social care, and welfare) can be adopted to understand how care may be evidenced within sport organisational practices and what value demonstrating care may have in enhancing relations between organisations and their constituents. In terms of how relationships are conceived in this context, theorists remind us that all human (and by extension business) relationships are imbued with moral obligations. More specifically, while moral obligations may vary between parties, there are inherently individual and collective values, ideals, and beliefs that warrant respecting, protecting, and nurturing (Pettersen, 2011; Tronto, 1993). Care also entails values related to respect, dignity, fundamental rights, and civic duties. Fundamental to an ethics of care, theorists argue, is a universal commitment to human flourishing, condemnation of exploitation and hurt, and conviction to do no harm (Pettersen, 2011). Although not an explicit component of sport organisations’ current practices, care essentially matters because it reiterates the importance of human empathy and understanding that lays at the heart of interaction. In essence, care cannot be divorced from sport organisations’ athlete business. In giving attention to care within welfare discourse, it is thus possible to understand and appreciate that sport organisational work is not ethics or value-­free but rather comprises (or should comprise) moral and ethical dimensions and virtue positions. It is necessary to recognise here, however, that caring is not a unilateral process. Rather, the notion and practice of care require an acknowledgement that each party (in this case the sport organisation and athlete) possesses independent ethical positions (which may vary considerably) and understands their moral obligations and responsibilities differently and thus requires respect and protection. It may be possible that sport organisations appreciate that care ethic matters in their work. Yet, as far as current programmes suggest, it remains uncertain as to how genuine this care is or whether care is used as a proxy for ulterior means and ends (i.e. good governance accountability, monitoring and evaluation maxims, or to achieve funding imperatives). Given these concerns, and guided by theoretical criticism of care ethics, we contend that care is not just a practice (i.e. welfare is not just something that is ‘done’ by an organisation to athletes). Rather, care is a disposition and not an act performed for bureaucratic measure. Furthermore, we argue care is something that should be evidenced across organisational systems and processes and felt by its constituents in their day-­to-­day working lives and experiences. Welfare, for example, should be part of an organisational–athlete state of relations, embedded in the ethos as opposed to something that is ‘done’ to athletes as part of organisational bureaucracy. We recognise that our argument starts from a philosophical (and perhaps idealistic) standpoint. We appreciate, also, that there is a futility and fragility in being able to ‘capture’ an affective concept (for extended discussion of conceptual conundrums, see Hughes, Kohe & Purdy, 2019). Here, a natural inclination is a recourse to employ the language of measurement and quantification to ascribe a ‘meaningful’ value to care that might be easily understood. These caveats withstanding, what we take interest in is how sports organisations might engage with holistic characteristics of care and create a context in which a recognised/recognisable shared set of values can be articulated, understood, and respected in a meaningful way. Tronto’s (1993) work is of use in understanding the complexities of care and organisational responsibilities, attitudes, and activities to care. It reminds us that caring comprises both rational explications of needs and emotional sympathy (two principles that are not readily explicated in sport organisations’ welfare approaches). Tronto (1993) raises questions with respect to care, in particular: Who are the caregivers? What relations exist between the carer and the care-­recipient (Tronto has less consideration for care as a bilateral process)? Who holds responsibilities, and how are those responsibilities enacted? What conflicts emerge? Nonetheless, Tronto encourages us to analyse our own activities of care and critically examine the consequences that care dynamics have in organisational settings and relations. Within these examinations, there must 38

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be an evaluation of the stakeholders’ values and expectations (i.e. in our case, athletes, sports workers, sport organisations’ approaches regarding the conceptualisation and practice of care). The potential uncertainty of transitional moments for athletes means this is a juncture at which sport organisations may need to demonstrate greater attention to care. At present, sport organisations provide a range of support mechanisms for athletes (e.g. the IOC’s Athlete365 programme and the corporate Athlete Career Transition [ACT] programme – discussed subsequently). Moreover, this work is becoming representative of what care looks like in the industry. With respect to evidencing care within transitional moments, athletes’ individual situations may be complex and idiosyncratic. Therefore, what sport organisations have done (at least in the examples we illustrate subsequently) is simplify the practice of care to ensure the ‘greatest good for the greatest number’. Inherently, universal care is not the same, necessarily, as the sort of bespoke care that some athletes desire. Nonetheless, sport organisations are having to find some middle ground in determining the extent of universal care coverage and a responsiveness to specific athletes’ personal needs. Transitional services, at present, are evidence of the blurred lines/tightrope that organisations are having to negotiate.

‘Caring’ practice In the media, a call has been made by professional athletes across a number of sports for organisations to better respond to their needs and experiences by providing specific care and welfare structures. Such structures cannot, nonetheless, just exist in the ether of discussion but rather must take tangible form(s) that can be seen, understood, engaged with, and evaluated in terms of their effectiveness in addressing athlete concerns. To these ends, some sport organisations have invested substantially in developing defined programmes, strategies, and initiatives related to transitions (and relatedly employment, dual careers, and retirement) that directly speak to athletes’ concerns, provide discernible content with which they can engage, and have outcomes that may be visibly recognised and/or have a clear meaning for athletes’ individual lives. However, what seems to have transpired is that in trying to provide ‘appropriate’ support for the masses, sport organisations (for example, the IOC) have had to overgeneralise, stereotype, and decontextualise in order to make programmes relevant to the widest possible cohort and be able to be utilised by a broad range of sport federations and NOCs. This approach has, invariably, been effective in fulfilling the IOC’s obligations as a leading sport entity and agendas toward appeasing and placating athletes’ concerns and wider public and political scrutiny. Moreover, in the absence of welfare and career programmes at the local and national levels, or where athletes deem existing domestic programmes insufficient, the IOC’s approach may provide a suitable option or substitute. Similarly, these macro-­scale programmes may be considered a complementary resource to fill in knowledge and practical gaps in information that local organisations may be unable to provide. Irrespective of intention, scope, and applicability in addressing contemporary concerns about athletes’ welfare and wider career trajectories, questions may still be asked about the ethical intentions of the organisation and meaningfulness of the programme’s reception. To understand the general scope and nature of existing provisions regarding athlete welfare related to career transitions, it is useful to look at a few key features. In the IOC’s flagship initiative Athlete365, for example, there is an explicit focus on career transitions and providing athletes with generic knowledge, skills, and attributes deemed of value in future employment (see IOC, 2018). While athletes may dip in/out of this programme in varied ways, the starting point for stimulating reflection, introspection, and discussion is in the tapping into athletes’ mental health and providing reassurance, particularly related to identity crises, feelings of loss 39

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and despair, sense of belonging, lack of direction, emotional instability, depression, and anxiety. Subsequently, as part of this reality check, Athlete365 encourages athletes to turn these potentially negative yet natural experiences and thoughts to positive means and ends vis-­à-­vis career development and employment. As such, in addition to providing opportunities for athletes to participate in online professional development workshops and utilise training ‘tool kits’ and psychometric self-­reflection exercises, there is an emphasis on encouraging the athlete to develop/ work on personal attributes (i.e. ‘resilience’, ‘coping’, ‘adaptability’, risk mitigation, and appropriate ‘mindsets’) that may serve them during dual-­career phases and/or at transitional points. Athlete365 also encourages athletes to be proactive and recognise their existing resources, to take advantage of their ‘networks’, and to facilitate connections to business and industry. There is a distinction between international or national federation-­level programmes and those offered by private entities. External providers, for example, have developed a relatively comprehensive suite of programmes and initiatives to ease athlete transitions. One example, the Athlete Career Transition programme (ACT, n.d., see www.athletecareertransition.com/), moves beyond the provision of online resources that engage athletes in consideration of career transitions (i.e. Athlete365) and provides an individualised, face-­to-­face programme. Using connections between the athletes and employers who are part of the network, ACT draws upon psychometric testing that is utilised to identify options and opportunities for future careers. Working with partner organisations in a variety of industries around the globe, ACT focuses on mobilising the transition from sport to a future career. The approach has been to treat welfare as something that can be assessed/evaluated (by way of psychometric tests), ‘understood’, and ‘managed’. Here, care can be conceptualised as the athlete being appropriately equipped with the personal and professional skills that enable them to manoeuvre beyond sport and transition successfully into a defined career. In this context, care equates to, and is framed as, ‘support’, ‘guidance’, individualised mentorship, effective network building, and (positive) career success. There are evident advantages for athletes engaging in the ACT programme in terms of having access to a supportive, bespoke, and caring transition process. First, the programme goes beyond that of the IOC’s Athlete365 initiative, as it addresses the need for increased social support by providing athletes with access to, and encouragement to develop, appropriate employment/industry networks. For athletes, this is potentially empowering, as they can feel a greater degree of agency in their own post-­sport trajectory. The professional and personal skills being developed in the programme, for example, may give athletes confidence and a sense of security and ownership over what resources they currently have at their disposal, what responsibilities they can take in determining their own destiny, and what that destiny might ultimately look like. The emphasis in the programme is not necessarily ensuring a smooth transition but on identifying/equipping athletes with a suitable skill set that aids the way they experience whatever type of transition they may be presented with. As stated on its website, “ACT have also developed a transition assistance program[me] that works constantly with the athlete to mentally prepare the athlete for their transition”. While ACT’s bespoke approach has merit, transition care has a financial cost that may make it prohibitive to a wider audience of athletes and sports organisations who could benefit from such a programme. Furthermore, the programme appears to be heavily based on psychometric testing that codifies the transition process into a series of understandable variables (i.e. things that can be measured and assessed). Consequently, care is reduced to something that can be easily delivered within the parameters of either organisation budgets or, in the case of ACT, as part of an economically rationalised, commercialised business product.

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To produce a financially sustainable care service, organisations have had to rationalise and bureaucratise what the offer of care is, and, as a result of this, assumptions have had to be made (i.e. that athletes’ career transitions and careers may be linear/logical). There is the possibility that organisations’ transitional care responses overplay the role of formal employment, which may limit alternate ways of thinking about athletes’ development. Furthermore, such an approach may be limiting in how it frames employment outside of Western cultures or Western-­ derived employment models. Notions of work, identity, progression, development, family and community responsibilities, time, and age are culturally relative. As such, these particularly structured approaches may not coalesce with athletes’ individual world views. The relevance of culturally resonant programmes that better reflect or engage with nuances of identity and community, and more broadly epistemology, has already been highlighted by some scholars who note the incorporation of culturally cognisant concepts within professional athlete development as a means for organisations to demonstrate improved rapport and care (Erueti & Palmer, 2017). We concur with Erueti and Palmer (2017) on the value of such approaches, yet there remains scope for further work in this area.

Conclusion A particular notion of athlete welfare has become normalised in sport-­sector discussions and in the literature. In this chapter, we have expressed a concern that current initiatives will continue to result in approaches becoming institutionalised, standardised, and bureaucratised to the extent that if organisations do not subscribe to these programmes (or at least provide an indication that they intend to do so), they are deemed to be failing their athletes. There are overlaps here with the increased interest and pressure being placed within and across some organisations with respect to ‘good governance’ and, in particular, notions of ethical responsibility, transparency, accountability, and stakeholder representation and participation (i.e. greater inclusion of athletes within the organisation). This discourse has become reductionist and restrictive to thinking about welfare and care ethics in ways that may be more holistic and that exist beyond the current provision of formally prescribed programmes. We advocate for a broader understanding of athlete welfare and a conceptualisation of care that advances sport-­sector welfare debates and approaches. Subscribing to more nuanced readings of care may be helpful, we suggest, in informing how we understand sport organisations’ capacities and the limitations that may influence athlete transition experiences. The call now is to find ways that athlete-­centred and responsible organisational welfare approaches may coalesce more carefully.

References ACT (n.d.). Athlete career transition: Applying the champion mindset of athletes in business. Retrieved from: www.athletecareertransition.com Alfermann, D., Stambulova, N. & Zemaityte, A. (2004). Reactions to sport career termination: A cross-­ national comparison of German, Lithuanian, and Russian athletes. Psychology of Sport and Exercise, 5(1), 61–75. Butt, J. & Molnar, G. (2009). Involuntary career termination in sport: A case study of the process of structurally induced failure. Sport in Society, 12(2), 240–257. Dimoula, F., Torregrosa, M., Psychountaki, M. & Gonzalez Fernandez, M. D. (2013). Retiring from elite sports in Greece and Spain. The Spanish Journal of Psychology, 16(E38). doi:10.1017/sjp.2013.18 Erpič, S. C., Wylleman, P. & Zupančič, M. (2004). The effect of athletic and non-­athletic factors on the sports career termination process. Psychology of Sport and Exercise, 5(1), 45–59.

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Erueti, B. & Palmer, F. (2017). Maori elite athletes and the expression of ethno-­cultural identity in sport. Sport in Society, 18, 1061–1075. Girginov, V. (2017). UK: England: National governing bodies of sport and government agencies. In Scheerder, J., Willem, A.  & Claes, E. (Eds.), Sport policy systems and sport federations (pp.  283–302). London: Palgrave Macmillan. Grey-­Thompson, T. (2017). Duty of care in sport: Independent report to government. Retrieved from: https:// assets.publishing.service.gov.uk/government/uploads/system/u ploads/attachment_data/file/610130/ Duty_of_Care_Review_-­_April_2017__2.pdf. Hughes, C., Kohe, G. Z. & Purdy, L. G. (2019). Playing nostalgic language games in sport research: Conceptual considerations and methodological musings. Quest, 71(4), 517–532. International Olympic Committee (2018). Athlete 365. Retrieved from: www.olympic.org/athlete365/ career/make-­your-­career-­transition-­a-­successful-­one/ Knights, S., Sherry, E. & Ruddock-­Hudson, M. (2016). Investigating elite end-­of-­athletic career transition: A systematic review. Journal of Applied Sport Psychology, 28(3), 291–308. Martin, L. A., Fogarty, G. J. & Albion, M. J. (2014). Changes in athletic identity and life satisfaction of elite athletes as a function of retirement status. Journal of Applied Sport Psychology, 26(1), 96–110. Pearson, R. E. & Petitpas, A. J. (1990). Transitions of athletes: Developmental and preventative perspectives. Journal of Counseling and Development, 69, 7–10. Perna, F. M., Ahlgren, R. L. & Zaichkowsky, L. (1999). The influence of career planning, race, and athletic injury on life satisfaction among recently retired collegiate male athletes. The Sport Psychologist, 13, 144–156. Pettersen, T. (2011). The ethics of care: Normative structures and empirical implications. Health Care Analysis, 19(1), 51–64. Schlossberg, N. K. (1981). A model for analysing human adaptation to transition. The Counselling Psychologist, 9(2), 2–18. Shilbury, D. & Ferkins, L. (2011). Professionalisation, sport governance and strategic capability. Managing Leisure, 16(2), 108–127. Stambulova, N. (2003). Symptoms of a crisis-­transition: A grounded theory study. In Hassmén, N. (Ed.), SIPF yearbook 2003 (pp. 97–109). Örebro, Sweden: Örebro University. Stambulova, N., Alfermann, D., Statler, T. & Côté, J. (2009). ISSP position stand: Career development and transitions of athletes. International Journal of Sport and Exercise Psychology, 7(4), 395–412. Stambulova, N., Franck, A. & Weibull, F. (2012). Assessment of the transition from junior to senior sports in Swedish athletes. International Journal of Sport and Exercise Psychology, 10(2), 1–17. Stambulova, N., Stephan, Y. & Jäphag, U. (2007). Athletic retirement: A cross-­national comparison of elite French and Swedish athletes. Psychology of Sport and Exercise, 8, 101–118. Tacon, R. & Walters, G. (2016). Modernisation and governance in UK national governing bodies of sport: How modernisation influences the way board members perceive and enact their roles. International Journal of Sport Policy and Politics, 8(3), 363–381. Taylor, J. & Ogilvie, B. (1994). A conceptual model of adaptation to retirement among athletes. Journal of Applied Sport Psychology, 6, 1–20. Tronto, J. (1993). Moral boundaries: A political argument for an ethic of care. London: Routledge. Warriner, K. & Lavallee, D. (2008). The retirement experiences of elite gymnasts: Self identity and the physical self. Journal of Applied Sport Psychology, 20, 301–317. Wylleman, P., Alfermann, D. & Lavallee, D. (2004). Career transitions in sport: European perspectives. Psychology of Sport and Exercise, 5(1), 7–20. Wylleman, P.  & Lavallee, D. (2004). A  developmental perspective on transitions faced by athletes. In Weiss, M. (Ed.), Developmental sport psychology (pp. 507–527). Morgantown, WV: Fitness Information Technology.

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4 Athlete shaming and the ethics of care Opposing forces in sport coaching Emily McCullogh and Parissa Safai

A magnifying moment We were midway through the season with few wins to show for our efforts. The head coach and I had designed an assignment that required all the athletes to reflect on what part volleyball played in their lives – a way of communicating to the team and coaches how committed they were to the sport and why they had decided to play at the competitive level. But something had gone terribly wrong with the exercise.   The head coach had just asked one of the athletes if they were prepared to present to the team and the athlete had answered, “No.” Instantly and visibly angry, the head coach began screaming at the athlete about their disappointment in the athlete’s lack of preparation and commitment to the team; the athlete was called an “embarrassment.” It was clear that no one on the rest of the team expected such a reaction, including me. I felt my weight shift back and forth between the balls of my feet and my heels as I struggled to maintain a face that did not reveal my shock. My hands were clasped tightly behind my back, writhing in discomfort. I could see and feel not only the discomfort on the face of the scolded athlete, but also on the faces of the other athletes standing around. They were paralysed by the coach’s reaction and words. I was paralysed by the coach’s reactions and words. And we were all silent as the coach raged. The tension in the gym was palpable. The coach gave the athlete another day to present and dismissed the team to begin their warmup. As the athletes walked away from us, the head coach continued to shout loudly about how embarrassed they were with this athlete’s inaction. The air remained heavy and the coach’s mood did not shift for the entire 90 minutes of practice. No one spoke about the explosion.   I played years of competitive sport myself before turning to coaching; I  knew how authority and hierarchy worked in sport. On this team, I’m the assistant coach; again, I know how authority and hierarchy in sport works. In the moment, there was no place for me to communicate my disappointment in the head coach’s methods. In the middle of this explosive moment, thoughts were racing through my head a mile minute: “This is not the way to handle this!” “How could you treat another human being this way?” “Is this the example you want to set for your athletes?” And yet I was silent, we all were silent. 43

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  A week later, I approached the head coach in private. I made it clear that I was completely against this method. I agreed that there should have been a serious conversation with this athlete with regards to their commitment to the team, but what happened was an unacceptable way to speak to anyone. Quick to defend, the head coach claimed that it was within their right to react that way – the athlete disobeyed the coach’s directive and needed to know that this disrespect wouldn’t be tolerated. In fact, the team needed to learn this lesson too. While in the moment, the head coach’s reaction seemed a reflex action. Here within the privacy of the coach’s office, I began to suspect, with a sinking feeling in the pit of my stomach, that the head coach’s reaction was calculated. I left the office in silence.

Drawing on the primary author’s personal experiences, the previous narrative represents a moment that magnifies the formidable nature of power relations between coaches and athletes in competitive sport. While there was no physical violence between coach and athlete, the explosive nature of the coach’s reaction to a student-­athlete’s failure to complete a particular assignment operated much like physical force in overpowering and dominating the others in the gym. It is important to note that the first author’s experience with this head coach was not always negative. It is, in fact, because the first author was witness to many effective and positive exchanges between this head coach and the athletes that this moment of shame and shaming in sport figures as so jarring and reflective of the complex and messy nature of sport coaching (Bowes & Jones, 2006). Within the critical sport coaching literature, less is known about the ways in which shame – defined as “a painful feeling of humiliation or distress caused by the consciousness of wrong or foolish behaviour” (Oxford Dictionaries online, n.d.) – and shaming – defined as the act of making one feel shame or ashamed – articulate with athlete care and welfare. Equally, little is known about how shame and shaming operate in coach–athlete relations as tools of power employed by coaches in their coaching practice and as harm experienced by athletes. Drawing on feminist philosophical writings on the ethics of care (EoC), this chapter aims to address this gap by mapping out a relationship between welfare and care and putting forth the arguments that shame and shaming articulate as practices that emphasise the lack of athlete care or welfare (as profoundly uncaring) and as social phenomenon intimately connected to hierarchies of power in sport coaching. Whereas there may be instances where shame is an emotion that we can trigger in ourselves, the tools of shame and shaming to which we are referring in this chapter function differently and, we argue, are more worrisome, as they occur when a leader in a position of power calls upon a subordinate to feel and act out of shame with, often, no warning, no opportunity for negotiation or dialogue, and in the presence of others (whether a real audience or an internalised audience). This approach to shame and shaming in sport can be most likely be followed up with an experience of self-­shaming which, when combined with versions of being shamed by those in authority, should heighten our concern for athletes’ welfare and well-­being. The chapter concludes by advancing the position that sport coaching is a caring profession, one that is responsible for the care of athletes within the complex institution of competitive sport, and that more research on care in sport is necessary.

The social and paradoxical nature of shame and shaming In this chapter, we readily acknowledge the complex nature of shame and shaming in our lives and psyches but purposefully locate shame and shaming as complex and fraught expressions of maltreatment in sport. Whereas there are some who suggest that shame has the potential to be constructive or morally empowering (i.e. Aldrich, 1939; Nussbaum, 2004), our central 44

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argument about shame is that it is grounded in values of domination and violence and that it is negative and harmful to the person being shamed. Shame is not just a blow to one’s psyche but, as Ahmed (2004, p. 103) notes, “an intense painful sensation that is bound up with how the self feels about itself, a self-­feeling that is felt by and on the body”. An individual who has been shamed experiences a sense of disconnect from a social group and thus challenges the sense of self constructed within the context of group membership (Williams & Long, 1993). For the one who is shaming, as Calhoun (2004) notes, shame acts to impress one’s moral expectations on others and can serve to exemplify, by contrast, how the shamer adheres to established norms. What is implicitly (and most likely without conscious awareness) woven into the shamer’s experience is their own shame insofar as that, in shaming others, people often “conceal something about themselves that occasions shame for the shamer” (Calhoun, 2004, p. 296). Shame, then, plays a role in regulating social interaction (Scheff, 2003). An awareness of the scenarios in which one would be called on to feel shame can act as a mediator or deterrent for behaviour within a group (Williams & Long, 1993). For those who see shaming as potentially constructive, shame, in this view, is a way of expressing and reinforcing shared moral values. But this does not ease the worry of those who question and criticise the use of shame and shaming to buttress (supposedly) accepted and shared social norms. Many are critical of shame being used as a tool in this way, since, while the intent of the shamer may be reintegration, the impact of shaming is wholly negative, uncontrollable, and ultimately uncaring (Brown, 2012). In the sport context, when a coach calls upon an athlete to feel shame for a real and/or perceived transgression (i.e. for not doing the assigned homework), they are moving (or, at very least, attempting to move) the athlete to a place of discomfort and embarrassment grounded in self-­perceptions of inadequacy in the context of the athlete’s peer group or team. Coaches who single out an athlete in this way are (re)affirming the standards of the group by signalling how this particular individual has (supposedly) deviated. The driving motivation behind this method could be understood as a deterrent for future violations, not only for the athlete in question but also for the audience acting as witness to the transgressor’s comeuppance. Furthermore, a sport coach may understand their athlete’s violation of team code as an act designed to resist, disrespect, and/or diminish the coach; in other words, to make the coach feel resisted, inadequate, and shameful. The coach’s act of shaming the athlete – in addition to solidifying and re-­solidifying established group norms – operates both as a decisive response to their own experience of inadequacy and an explicit (re)affirmation of the coach’s dominance and authoritative role in the team. We must acknowledge that shame and shaming shake out as described previously when the intended shame/shaming is received and internalised as such by the intended target. In other words, a coach could try to shame an athlete and the athlete could laugh it off as nothing substantial or real because the attempt at shaming does not resonate with their core beliefs, values, or sense of personal esteem. However, to be clear, and as we note again later in the chapter, one of the concerns we raise in this chapter centres on the dangerousness of shame/ shaming as coaching tools because of the inherent unpredictability of shame and shaming  – there is no way of knowing ahead of time or controlling how deep a cut, if any, the tactics of shame and shaming make onto the minds and bodies of athletes. Shame and shaming are expressions of power – one cannot shame another unless they exert their power or, at minimum, attempt to exert their power over another (Probyn, 2000). What makes shame and shaming in the sport context so troubling is that the nature of power relations between athletes and coaches, specifically, is a priori inequitable (see Jowett & Cockerill, 2003; Tomlinson & Yorganci, 1997). The social institution of sport is imbued with hierarchy in which, with rare exception, coaches exercise more power than athletes (cf. Shogan, 1999). While we have no doubt that there are many coaches who are committed to balanced power 45

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relations within their teams and who foster feelings of reciprocity between themselves and their athletes, we are sadly all too familiar with examples of coaches who exert undue influence on their athletes and/or who use and abuse their power as coaches over their athletes. Shaming has an insidious quality in that it has the ability to hide beneath methods unintended to shame but that, upon application, result in shame. Coaches may use shame as a tool, under the guise of good intent and ‘teaching a lesson’ without conscious intent to abuse an athlete. However, given the unpredictable and uncontrollable negative consequences of shame, shaming is a worrisome and high-­r isk approach, as a coach cannot be certain that it is not experienced as damaging to an athlete’s sense of self-­worth and well-­being. The majority of coaching literature focuses on the ways in which coaches learn and produce knowledge (Abraham & Collins, 1998; Bloom, Stevens & Wickwire, 2003; Bowes & Jones, 2006). Coaches, positioned as leaders with expert knowledge, must be aware of how the power embedded in their roles can affect the impact of their decisions and interactions with their athletes. We maintain, as do many others, that a coach’s role is more than just the teaching of technical, sport-­specific skills – a coach is also responsible for the welfare of their athletes, fostering social bonds between their players, and maintaining the psychological, social, and physical spaces where athletes can learn of themselves and their craft (Côté & Gilbert, 2009; Jowett & Cockerill, 2002; Naylor, 2006). The methods and tactics employed by a coach must maintain, protect, and enhance an athlete’s sense of self, well-­being, and competence in order to support their growth in sport. Coaches who turn to shaming as a coaching strategy, a method that is profoundly disempowering, are not considering the possible negative impacts on the athlete being singled out or, if they are aware of the negative consequences, are choosing to maintain, protect, and enhance other goals (i.e. the win or the record) beyond their athlete’s sense of self, well-­being, and competence (Cumming, Smoll, Smith  & Grossbard, 2007; Potrac  & Jones, 2009). Shifting the focus towards athlete welfare as the primary goal gives coaches the (potentially daunting) task of prioritising player health, safety, happiness, and prosperity above winning and away from competitive outcomes. This is a strategy that, while imbued with care and caring, is many times not well supported by those types of sport organisations that position themselves towards, are focused on, and are dedicated to elite performance and performance success (Naylor, 2006). Of course, not all sport organisations operate within the narrow confines of high-­performance sport where winning and performance excellence are situated as the central goals of the organisation, nor do they subscribe to the success-­at-­any-­cost ethos (Lang, 2010). Furthermore, we must acknowledge that not all those who work within elite sport organisations prioritise win-­loss records above athlete welfare; rather, there can be (and often are) complex and, at times, complicated negotiations between administrators, coaches, officials, and even athletes as it relates to player welfare and sport performance (cf. Hartill & Lang, 2014). For us, and given our focus in this chapter, coaches have a substantial responsibility for maintaining and ensuring the protection of athlete welfare and must refrain from behaviours that would be considered abusive, maltreatment, or uncaring; welfare is attended to when coaches refrain from shaming. We argue that this requires an explicit investment in care and caring by sport coaches and a re-­locating of the profession of sport coaching from one centred on pedagogy to caring. Both of these points require an explicit integration of an ethics of care into the foundations of sport coaching.

Mapping welfare and care in sport through feminist philosophy Research on power relations between coaches and athletes, as well as the abuse of a coach’s power over an athlete and the consequences of this abuse for athletes, is well established in the 46

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critical sociocultural study of sport coaching. Notable thematic areas include but are not limited to: the experience and (mis)treatment of child and youth athletes in the high-­performance sport system (i.e. Donnelly, 1997; Donnelly, Kerr, Heron & DiCarlo, 2014; Kerr & Stirling, 2008, 2012; Ryan, 1995; Stirling & Kerr, 2013), hazing and initiation as rituals of power over athletes (i.e. Johnson & Holman, 2004; see also Jennifer J. Waldron’s chapter in this collection), and the sexual harassment and/or abuse of athletes by their coaches (i.e. Brackenridge, 1997, 1998; Brackenridge & Rhind, 2014; Crosset, Benedict & McDonald, 1995; Gervis & Dunn, 2004; Kirby, Greaves  & Hankivsky, 2000; Leahy, Pretty  & Tenenbaum, 2002; Toftegaard Nielsen, 2001). What is notable from the scholarship on this topic is that we have more certainty about what constitutes athlete maltreatment in sport than otherwise. In other words, it is easier for us to conceptualise and define harassment and abuse in sport than care and caring in sport and, in that, we run the risk of equating care and caring with the absence of mistreatment rather than defining care and caring in and of themselves. We acknowledge that it is easier to conceptualise harm and maltreatment, as evident by the greater volume of research on the lived experiences of such, but we position this chapter as an opportunity to approach sport and sport coaching from the perspective of care. Through this approach, abuse and maltreatment become included in a care framework as ‘uncaring’ and we, as researchers, can locate the evidence on uncaring as the first steps in figuring out what care is. In so doing, we respect the care and caring that do take place, as sport coaches already engage in daily care and caring (care work) whenever they adjust their practices and policies to their participants’ needs as they negotiate the experiences of unique humans (athletes) in a performance-­ centred system (organised, competitive sport). How, then, do we, in this chapter, define care, caring, and welfare? Drawing on feminist philosophy, our point of departure resides in acknowledging that care and welfare are relational concepts, not endpoints or final states. This approach also prioritises the lived experiences of those in subordinate positions of power. In its classical use, welfare referred to ‘happiness’ as the minimum ‘good’, which is understood as the net balance of pleasure over pain that the individual experiences (Bentham, 1789; as cited in White, 2015). More contemporary philosophers (outside of sport) posit that ‘welfare’, or ‘welfarism’, refers to the relation between a ‘social minimum’ and a ‘social minimum policy regime’. A ‘social minimum’ refers to the resources required for a person to lead a minimally decent life in their society, while a ‘social minimum policy regime’ refers to the set of rules or regulations that secures every member’s reasonable access to this minimum (White, 2015). While through a philosophical and ethical lens, welfare still retains an abstract quality, there is a concrete underpinning within welfare and welfarism that the intent of social policy is to ensure a minimum standard of ‘good’ for all who are subject to the rules of society (White, 2015). In extending this definitional work to the concept of care, feminist philosophers, particularly those who advance an ethics of care, posit that care is a relational ideal and that to care “may mean to be charged with the protection, welfare, or maintenance of something or someone” (Noddings, 2013, p. 9). The EoC relational ideal is one where we care for others because that is a way of caring for ourselves. The needs of self and other are held as equally valuable, and the intention of caring is continually reciprocated. However, in relations of unequal power, such as between coach and athlete within the structure of an institution such as sport or within an organisation like a sport team, then responsibility must follow suit. To balance out the unequal power relations and to protect the vulnerable, sport coaches ought to put athletes’ needs before theirs most of the time. In this sense, welfare is a minimum expression of care focused centrally not on what ought to be prohibited but what ought to be done in “the protection . . . or maintenance of something or someone” (Noddings, 2013, p. 9). The 47

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status of an athlete’s welfare cannot be determined by an objective measure but instead is a subjective experience of a minimum level of care. Thus, currently, the term ‘welfare’ is most valuable when considered broadly, as a way to categorise an experience or state of being that ought to be upheld for all athletes. Within the EoC, a model that is centrally concerned with the nature of human relations as caring relations, our attention is redirected “away from concerns about right judgments and their ethical justification in order to focus instead on how we can best meet each other as [caring] and how we can create and enhance caring relationships” (Diller, 1988, p. 330). The EoC does not provide universal, formulaic, or impartial prescriptions for all caring relationships, nor does it seek to avoid conflict within relationships. Rather, “it provides standards [grounded in values that reject domination and violence] by which to evaluate care practices and recommend better ones” (Held, 2006, p. 4).

The ethics of care in the context of sport coaching The EoC is not unheard of within the critical sociocultural study of sport coaching, and we do not think it too bold to suggest that it will become increasingly popular among those researchers and practitioners who are personally and professionally interested in better understanding and advocating for more care and caring in sport coaching. While some suggest that an EoC is a guiding principle necessary to ensure that the sport environment remains a space where athletes learn moral behaviour (Duquin & Schroeder-­Braun, 1996; Gearity & Denison, 2012), others have examined how coaches see themselves as caring for their athletes (Jones, Bailey  & Santos, 2013; Knust  & Fisher, 2015). For example, Jones (2009, p.  388) outlines the importance of an EoC in nurturing the full potential of athletes: “we are to give them our attention, our engrossment, our care; both on and off the field”. We wholeheartedly agree with Jones’s call and extend this work by exploring shame and shaming as uncaring in sport coaching through the EoC lens. Whereas sport offers a pre-­determined set of roles that are governed by institutional guidelines, the EoC offers standards for coach behaviour and practice that are contextually specific and grounded in lived experience, requires coaches to constantly displace their own desires in efforts to understand their athletes’ experiences from their perspective, and serves to protect and enhance athlete welfare above all. The EoC does not influence what coaches teach but rather how coaches interact with their athletes (Erickson & Côté, 2016). Within the sporting context, the EoC’s attention to human flourishing requires coaches to attend to their athlete’s entirety as a human being and not just to those elements of the athlete’s identity that operate on the court or in the arena. A coach who only sees their role as helping to develop the athlete’s skill acquisition or performance has failed to recognise the complexity of the individual and thus has failed to commit to that athlete’s welfare. Welfare necessarily involves placing the needs of the cared for ahead of one’s own, and this presents a challenge within the context of sport, as coaches must balance their own (or management’s) aspirations and goals with the needs of their athletes; in some cases, these wants and needs may not align. In many cases, the end goal of winning may compromise the welfare of athletes, particularly when individual teaching and learning moments (process) are rushed, bypassed, or damaged for the sake of winning (outcome). In applying the EoC to sport, we protect the athlete as more important than the sport by honouring their unique position and process. In this light, shame and the shaming of athletes for misconduct (real or otherwise) violate the standards of the EoC in a multitude of ways (all of which are reflected in the primary author’s personal anecdote shared at the beginning of this chapter). Due to the negative effects and the 48

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uncontrollable consequences of shame, shaming cannot be done in any way that preserves or protects athlete welfare. Care ethics necessitate that a coach set aside their own wants and needs in order to protect and enhance their athletes, and yet shaming is inherently about displacing one’s sense of self in order to (re)assert the shamer’s (and group’s) established norms. Furthermore, the EoC demands reflexivity and attentiveness on the part of the one caring – a coach who freely shames his/her athletes displays a lack of attention to their psychological, emotional, and physical reactions. This is further complicated by those coaches who rationalise their shaming as somehow appropriate or valuable for athletes, since such rationalisation indicates an acceptance of coaching tactics grounded in, to varying degrees, domination and violence. Even if it appears that an athlete has improved as a result of being shamed, there is no way of discerning whether the athlete has genuinely learned from the experience in positive, productive, and long-­term ways or has internalised feelings of inadequacy and is merely performing in order to avoid being shamed again in the future (which, problematically, could be interpreted by the coach as a successful outcome of shaming and therefore fuel the continued use of shaming as a coaching tactic). What makes the sport context so particularly dangerous with regard to shame and shaming is the way in which the social, political, and cultural institution of sport protects hierarchy and coaches within hierarchy. As noted already in this chapter, within sport, coaches possess authority often not equally matched by their subordinates (athletes or even junior coaches) and, therefore, have disproportional power to silence dissenting or resistant voices through shame and shaming. We are not suggesting that all athletes are always passive recipients of a coach’s authority; athletes do have agency and can exercise this agency in a myriad of a ways from tolerance to outright resistance/rejection (or even a combination of different approaches) of a coach’s attempt to shame them. And, in some cases, the athlete is so exceptional and celebrated that their athletic capital is on par with or even outweighs a coach’s position of authority within the sport hierarchy. However, we stress that there is inherent inequality with regard to power dynamics within sport, such that coaches enjoy power not routinely distributed equally among all sport participants – for example, a coach can bench a player, but what player can bench a coach? This dynamic, and its risk for abuse, demand attention to asserting sport coaching as a caring profession.

Sport coaching as a caring profession Sparked by an intense and uncomfortable witnessing of shaming in sport, this chapter has attempted to show the need for care and caring approaches to attend to the specific harm of shame. On one hand, as noted earlier in the chapter, the institution of sport a priori facilitates an imbalance in power between coach and athlete. In sport, the athlete does not enjoy the same level or type of power or authority that a coach enjoys and, thus, it is not clear if athletes are able to respond to caring methods (or the absence of) in the way the EoC purports the cared for should be able to do. The moment described in this chapter draws attention to the dangers that exist for athletes in sport because the structure of sport minimises their agency, and yet the EoC assumes a certain measure of capacity on the part of the athlete to act independently, to make decisions, and to have a voice. We argue that there is tremendous value in the EoC in shifting our collective gaze towards the importance of care in sport and to the importance of shifting coaches’ gaze to prioritising their relatedness to those for whom they are responsible. But much more research is needed to adopt and adapt the EoC appropriately to the sport context given the differentials of power between coaches and athletes as structured within the institution of competitive sport. We are quick to add that this call for more research is not just limited to the 49

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coach–athlete dyad in some sort of social vacuum. We would be doing a disservice to exploring the EoC in sport coaching without appreciating that coaches are themselves subject to pressures from administrators or sport organisations which, in turn, influence their capacity and ability to care for their athletes. Put differently, the famous quote, “winning isn’t the most important thing, it’s the only thing”, came from a coach who practised their craft in the National Football League (NFL) – an organisation long notorious for its lack of care for the welfare or well-­being of its players (Zirin, 2011). On the other hand, competitive sport is fundamentally about coaches coaching their athlete or teams to risk themselves and dominate their opponent in order to secure the win. In fact, some coaches would argue that they dominate their own athletes in order to show them how to dominate their sporting opponent and because they fundamentally care about their athletes. There are numerous cases (including in the magnified moment that sparked this analysis) where coaches have claimed that their methods – which in some cases would be understood as abusive outside of the sport context – are justified in the name of care and that they have their athletes’ best interests in mind. For example, in a 2012 case of the verbal abuse of an athlete at St. Michael’s University School in Victoria (British Columbia, Canada), a coach admitted that he was competitive to a fault but that he devoted many hours to his athletes so that they could improve playing the sport they love and that he continuously reinforced values of loyalty, teamwork, humour, unselfishness, and honesty (Cribb, 2015). Another even more shocking example is of Japanese basketball coach Komura Hajime, who beat and shamed one of his teen players so badly the boy ended up taking his own life. Hajime was prosecuted and said in court that he beat the player for his own best interests – to ‘toughen him up’, to teach him ‘discipline’, and to respect his status (see Miller & Nakazawa, 2015). In other areas of social life where forms of violence have been justified in the name of care (i.e. in the residential school system), measures are currently being taken to remove our collective ‘blinders’ to this abuse, to call it what it is, to attend to the needs and wants of the victims, and, we hope, to enact genuine change so that this abuse does not happen again (see Truth and Reconciliation Commission of Canada, 2015). In Canada, despite the relatively sporadic coverage in the popular media of athlete abuse at the hands of coaches, often focused on sexual abuse/harassment, the use of harmful sport coaching methods in the name of care has not received adequate and sustained attention. In calling for more research on care and caring in sport, we are sensitive to how the use of care language to justify harm and mistreatment complicates the application of the EoC to sport but argue that the EoC is still valuable in mobilising our collective attention and sense of action. We conclude by calling for the assertion of sport coaching as a caring profession, a call that is well aligned with an EoC, since this framework makes caring a personal and professional obligation for a sport coach and rejects any coaching practice that sacrifices care and caring. Caring professions are characterised by their attentiveness and responsiveness to others’ needs and by “seeing things from the perspective of the person needing care” (Lloyd, 2006, p. 1183). Much of the literature pertaining to caring professions has been limited to the field of social work and nurse practitioners; these professionals attend to individuals who are in need of care for their physical and psychological survival (Handy, 1991; Holroyd, Dahlke, Fehr, Jung & Hunter, 2009; Robinson, 1992; Slevin, 1991). While the stakes of sport are not always about surviving in the conventional sense of the word, we contend that asserting sport coaching as a caring profession does attend to the physical and psychological thriving of the athlete. Furthermore, we argue that this is not a stretch, as many coaches already engage in care and caring practices with their athletes. Seen in this way, our call for sport coaches to avoid shame and shaming and to strive towards care and caring as their central goal is a common-­sense one. 50

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References Abraham, A. & Collins, D. (1998). Examining and extending research in coach development. Quest, 50(1), 59–79. Ahmed, S. (2004). Shame before others: The cultural politics of emotion (pp. 101–120). Edinburgh: Edinburgh University Press. Aldrich, V. C. (1939). An ethics of shame. Ethics, 50(1), 57–77. Bentham, J. (1789). Introduction to the principles of morals and legislation, Chapters I–V. In Warnock, M. (Ed.), John Stuart Mill’s utilitarianism. Glasgow: William Collins. Bloom, G., Stevens, D. & Wickwire, T. (2003). Expert coaches’ perceptions of team building. Journal of Applied Sport Psychology, 15(2), 129–143. Bowes, I. & Jones, R. L. (2006). Working at the edge of chaos: Understanding coaching as a complex, interpersonal system. Sport Psychologist, 20(2), 235. Brackenridge, C. (1997). “He owned me basically . . . ”: Women’s experience of sexual abuse in sport. International Review for the Sociology of Sport, 32(2), 115–130. Brackenridge, C. (1998). Healthy sport for healthy girls? The role of parents in preventing sexual abuse in sport. Sport, Education and Society, 3(1), 59–78. Brackenridge, C. & Rhind, D. (2014). Child protection in sport: Reflections on thirty years of science and activism. Social Sciences, 3(4), 326–340. Brown, B. (2012). Daring greatly: How the courage to be vulnerable transforms the way we live, love, parent and lead. New York: Penguin. Calhoun, C. (2004). An apology for moral shame. Journal of Political Philosophy, 12(2), 127–146. Côté, J. & Gilbert, W. (2009). An integrative definition of coaching effectiveness and expertise. International Journal of Sports Science and Coaching, 4(3), 307–323. Cribb, R. (2015). Teachers’ bullying scarred us, say student-­athletes. The Star. Retrieved from: www.thestar.com/news/canada/2015/03/14/teachers-­bullying-­scarred-­us-­say-­student-­athletes.html Crosset, T. W., Benedict, J. R.  & McDonald, M. A. (1995). Male student-­athletes reported for sexual assault: A survey of campus police departments and judicial affairs offices. Journal of Sport and Social Issues, 19(2), 126–140. Cumming, S. P., Smoll, F. L., Smith, R. E. & Grossbard, J. R. (2007). Is winning everything? The relative contributions of motivational climate and won-­lost percentage in youth sports. Journal of Applied Sport Psychology, 19(3), 322–336. Diller, A. (1988). The ethics of care and education: A new paradigm, its critics, and its educational significance. Curriculum Inquiry, 18(3), 325–342. Donnelly, P. (1997). Child labour, sport labour: Applying child labour laws to sport. International Review for the Sociology of Sport, 32(4), 389–406. Donnelly, P., Kerr, G., Heron, A. & DiCarlo, D. (2014). Protecting youth in sport: An examination of harassment policies. International Journal of Sport Policy and Politics, 8(1), 1–18. Duquin, M. E. & Schroeder-­Braun, K. (1996). Power, empathy, and moral conflict in sport. Peace and Conflict: Journal of Peace Psychology, 2(4), 351–367. Erickson, K. & Côté, J. (2016). A season-­long examination of the intervention tone of coach-­athlete interactions and athlete development in youth sport. Psychology of Sport and Exercise, 22, 264–272. Gearity, B. T. & Denison, J. (2012). Educator-­coach as stranger. Cultural Studies↔Critical Methodologies, 12(4), 352–356. Gervis, M. & Dunn, N. (2004). The emotional abuse of elite child athletes by their coaches. Child Abuse Review, 13(3), 215–223. Handy, J. A. (1991). The social context of occupational stress in a caring profession. Social Science and Medicine, 32(7), 819–830. Hartill, M. & Lang, M. (2014). “I know people think I’m a complete pain in the neck”: An examination of the introduction of child protection and “safeguarding” in British sport from the perspective of national governing body Safeguarding Lead Officers. Social Sciences, 3(1), 1–22. Held, V. (2006). The ethics of care: Personal, political and global. New York: Oxford University Press. 51

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Holroyd, A., Dahlke, S., Fehr, C., Jung, P. & Hunter, A. (2009). Attitudes toward aging: Implications for a caring profession. Journal of Nursing Education, 48(7), 374. Johnson, J. & Holman, M. J. (Eds.). (2004). Making the team: Inside the world of sport initiations and hazing. Toronto: Canadian Scholars Press. Jones, R. L. (2009). Coaching as caring (the smiling gallery): Accessing hidden knowledge. Physical Education and Sport Pedagogy, 14(4), 377–390. Jones, R. L., Bailey, J. & Santos, S. (2013). Coaching, caring and the politics of touch: A visual exploration. Sport, Education and Society, 18(5), 648–662. Jowett, S.  & Cockerill, I. M. (2002). Incompatibility in the coach-­athlete relationship. In Cockerill, I. (Ed.), Solutions in sport psychology (pp. 16–31). London: Thompson Publishing. Jowett, S.  & Cockerill, I. M. (2003). Olympic medallists’ perspective of the athlete-­coach relationship. Psychology of Sport and Exercise, 4(4), 313–331. Kerr, G. A. & Stirling, A. E. (2008). Child protection in sport: Implications of an athlete-­centered philosophy. Quest, 60(2), 307–323. Kerr, G. A. & Stirling, A. E. (2012). Parents’ reflections on their child’s experiences of emotionally abusive coaching practices. Journal of Applied Sport Psychology, 24(2), 191–206. Kirby, S. L., Greaves, L. & Hankivsky, O. (2000). The dome of silence: Sexual harassment and abuse in sport. Halifax, Canada: Fernwood. Knust, S. K. & Fisher, L. A. (2015). NCAA Division I female head coaches’ experiences of exemplary care within coaching. International Sport Coaching Journal, 2(2), 94–107. Lang, M. (2010). Surveillance and conformity in competitive youth swimming. Sport, Education and Society, 15(1), 19–37. Leahy, T., Pretty, G. & Tenenbaum, G. (2002). Prevalence of sexual abuse in organised competitive sport in Australia. Journal of Sexual Aggression, 8(2), 16–36. Lloyd, L. (2006). A caring profession? The ethics of care and social work with older people. British Journal of Social Work, 36(7), 1171–1185. Miller, A. & Nakazawa, A. (2015). Who safeguards the child in Japanese sport? In Lang, M. & Hartill, M. (Eds.), Safeguarding, child protection and abuse in sport: International perspectives in research, policy and practice (pp. 133–140). London: Routledge. Naylor, A. H. (2006). The coach’s dilemma: Balancing playing to win and player development. Journal of Education, 187(1), 31–48. Noddings, N. (2013). Caring: A relational approach to ethics and moral education (2nd ed.). Los Angeles: University of California Press. Nussbaum, M. C. (2004). Hiding from humanity: Disgust, shame, and the law. Princeton, NY: Princeton University Press. Oxford Dictionaries Online (n.d.). Shame. Retrieved from: www.oxforddictionaries.com/definition/ english/shame Potrac, P. & Jones, R. (2009). Power, conflict, and cooperation: Toward a micropolitics of coaching. Quest, 61(2), 223–236. Probyn, E. (2000). Sporting bodies: Dynamics of shame and pride. Body and Society, 6(1), 13–28. Robinson, J. J. (1992). Problems with paradigms in a caring profession. Journal of Advanced Nursing, 17(5), 632–638. Ryan, J. (1995). Little girls in pretty boxes: The making and breaking of elite gymnasts and figure skaters. New York: Doubleday. Scheff, T. J. (2003). Shame in self and society. Symbolic Interaction, 26(2), 239–262. Shogan, D. A. (1999). The making of high-­performance athletes: Discipline, diversity and ethics. Toronto: University of Toronto Press. Slevin, O. Ď. (1991). Ageist attitudes among young adults: Implications for a caring profession. Journal of Advanced Nursing, 16(10), 1197–1205. Stirling, A. E. & Kerr, G. A. (2013). The perceived effects of elite athletes’ experiences of emotional abuse in the coach-­athlete relationship. International Journal of Sport and Exercise Psychology, 11(1), 87–100.

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Toftegaard Nielsen, J. (2001). The forbidden zone: Intimacy, sexual relations and misconduct in the relationship between coaches and athletes. International Review for the Sociology of Sport, 36(2), 165–182. Tomlinson, A. & Yorganci, I. (1997). Male coach-­female athlete relations: Gender and power relations in competitive sport. Journal of Sport and Social Issues, 21(2), 134–155. Truth and Reconciliation Commission of Canada (2015). The survivors speak: A report of the Truth and Reconciliation Commission of Canada. Ottawa: Truth and Reconciliation Commission of Canada. White, S. (2015). Social minimum. In Zalta, E. N. (Ed.), The Stanford encyclopedia of philosophy. Retrieved from: https://plato.stanford.edu/archives/win2015/entries/social-­minimum/ Williams, B. A. O.  & Long, A. A. (1993). Shame and necessity (Vol. 135). Berkeley, CA: University of California Press. Zirin, D. (2011). NFL labour pains and the press release that redefined chutzpah. Edge of Sports. Retrieved from: www.edgeofsports.com/2011-­03-­14-­607/index.html

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Part II

Current concerns in the welfare of athletes

5 Gendered violence in women’s artistic gymnastics A sociological analysis Natalie Barker-­Ruchti, Astrid Schubring and Carly Stewart

Introduction Since the 1970s, research and media have reported cases of violence in women’s artistic gymnastics (WAG). The USA Gymnastics sex abuse scandal1 is the most recent and prominent case of the global evidence of sexual, physical, emotional, and/or psychological violence gymnasts experience in this sport (e.g. Gertsch & Steffen, 2015; Gervis & Dunn, 2004; Hudson, 1995; Jacobs, Smits & Knoppers, 2016; Olaru, 2016; Pinheiro, Pimenta, Resende & Malcolm, 2012; Smits, Jacobs & Knoppers, 2016; Stier, 2012; Stirling & Kerr, 2013; Varney, 1999). Despite this global evidence, sociological analyses of violence in WAG are rare and often limited to particular cases or situations (e.g. the coach–gymnast relationship). One reason that Young (2015) offers for this gap is that violence in sport is shrouded in a world of secrecy and disguise, which complicates research through distrust, gatekeepers, and ethical obligations. A  further reason that feminist scholars put forward is that violence in sport has predominantly been examined without theoretical information, especially with regard to its gendered nature (an exception is Stewart, Barker-­Ruchti & Schubring, 2018).2 Feminist scholars examining violence against girls and women, however, argue that theoretically informed research is best equipped to generate effective policies and interventions (e.g. Jakobsen, 2014). In this chapter, we address this gap in theorising by bringing together a sociological perspective of violence and a feminist perspective of gender to explore how a theorising of violence as gendered can help us better recognise, explain, and potentially transform the violence gymnasts are reported to experience. To achieve this aim, we draw on Young’s (2013) concept of ‘sports-­ related violence’ (SRV) and Risman’s (2018) ‘gender structure theory’. In so doing, we propose that the theorising of violence as gendered provides us with a means to conceptualise WAG as a multilevel system of gendered ideals and norms, rules, apparatus, movements, relationships, practices, and individual subjectivities that create ‘a system of inequality’ that creates conditions for violent coach (and other) behaviour, but if any of the system’s elements are altered, may transform gender inequality and prevent violence against gymnasts. In the following, we first theorise the gendered nature of violence by bringing together Young’s conception of violence and Risman’s gender structure theory. Building further on this theory, we hypothesise how changing one element of the gendered system of WAG, for 57

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example, the leotard, could reduce the risk of gymnasts experiencing violence. We conclude the chapter by demonstrating how our procedure to identify the gendered underpinnings of violence in WAG can support researchers and sport stakeholders’ endeavours to examine how gender assumptions constitute sports and, importantly, how change can be initiated.

Gendering sports-­related violence From a sociological perspective, Young’s (2013, pp. 93–97) conceptualisation of SRV as a “complex web of ultimately overlapping social behaviours” is generative to understand violence in sport. Young’s conceptualisation of SRV does not isolate an act of violence from broader social and sport-­specific structures and processes. Rather, Young (2015, p. 642) argues that it is sociologically necessary to contextualise violent behaviour and closely scrutinise the “fundamentally sociological links and associations that underpin many, if not all, forms of SRV” in order to understand and transform it. The existing body of gymnastics research illuminates the violence gymnasts experience and the negative consequences this has for gymnasts. This research demonstrates the interrelations between social and sports-­related structures conceptualised in Young’s (2013) 18 formations or cells of SRV3 A key social structure, which Young (2007) recognises shapes sport actors’ socialisation to practise and accept violence, is gender. Young refrains, however, from gendering SRV in detail, which is why we turn to Risman’s gender structure theory to theorise the gendered nature of violence in sport. Risman (2018; see also 2004) conceptualises gender as a social structure that creates material conditions and processes relating to “our bodies and the legal rules that distribute physical rewards and constraints in any given historical moment” and cultural processes, which are widely shared ideologies and norms of bodies and social interaction. These conditions and processes influence individuals at the individual, interactional, and social levels to frame: the expectations each of us bring to every social encounter. Actors often behave without thinking about it, simply following habits that come to define the cultural meaning of their lives. The taken-­for-­g ranted and often unacknowledged conditions of action shape behaviour but do so as human beings reflexively monitor the intended and unintended consequences of their actions, sometimes reifying the structure, and sometimes changing it. (Risman, 2018, p. 35) What Risman (2018) acknowledges is that the gendered socialisation she conceptualises shapes individuals into how they experience their bodies (individual level), how they are expected to behave and are organised and represented by formal institutions (interactional level), and how they are ruled and categorised by governing bodies and legal systems (social level). These three levels interrelate, and each intersects with other social structures, particularly age, ‘race’, religion, and sexuality, which adds boundaries, or “axes of oppression”, to the system of inequality Risman (2018) proposes. Nevertheless, individuals and groups of individuals are able to actively interpret their gendered realities (i.e. gendered violence). Despite the endurance of ideologies, norms, and power, Risman (2018) and other scholars (Barker-­Ruchti, Grahn & Lindgren, 2016; Deutsch, 2007; Schubring  & Thiel, 2016; Stewart, 2018) credit individuals with the ability to resist gender structures, which they argue can destabilise and change gender equality. A key change to achieve this must occur to the “expectations that are attached to the status of male and female” (Risman, 58

Gendered violence in women’s gymnastics

2018, p. 27, emphasis our own). Risman sees particular potential if transformations are enacted by both institutions and individuals. Before we can identify appropriate such actions, we turn to demonstrating the gendered nature of violence in WAG.

Gendered violence in women’s artistic gymnastics Existing sociocultural WAG literature documents how the multitude of gendered ideals and norms, rules, and apparatus shape expectations. Research demonstrates, for instance, how since its beginnings, femininity prescribes the gymnastics body ideal to be thin and small and movements sexual and erotic (Cervin, 2020a; Haug, 1999; Wright, 1991). Research on media representations of gymnasts reinforce these prescriptions (Chisholm, 2002; Weber & Barker-­Ruchti, 2012). Moreover, scholars have shown how WAG’s gender ideal creates an unequal coach– gymnast relationship, which also contributes to violent coaching practices (Cervin, 2020b; Kerr, Barker-­Ruchti, Schubring, Cervin & Nunomura, 2019; Kerr & Cervin, 2016). Materials (e.g. gymnastics spaces and equipment, the leotard) have also been shown to be gendered (Barker-­ Ruchti & Tinning, 2010; Prinz, 1999; Stewart, Lord, Wiltshire & Fleming, 2010). Last, scholars have analysed the judging system using a gender perspective, which has shown that judges, as with photographers and journalists, are influenced by gender ideologies in appraising bodies and gymnastics performance (Weber & Barker-­Ruchti, 2012). How do these gendered ideals, norms, and practices generate SRV? Two of Young’s 18 formations of violence – cell 9, ‘sexual assault’, and cell 11, ‘offences by coaches/administrators/medical staff’ – are best known to describe this system and the violence gymnasts are reported to experience. WAG research has shown how both these forms of violence create the expectation that the coach should be authoritarian and the gymnast physically and mentally immature (Barker-­Ruchti, 2009; Theberge, 1993). This pixie-­style model, which a number of WAG researchers employ to describe this sport, explains how the majority of gymnasts are child athletes (girls) that are positioned as dependents and given minimal voice, while coaches are in control and expected to adopt authoritative coaching (Kerr, Barker-­Ruchti, Schubring, Cervin  & Nunomura, 2019). This gendered power relationship facilitates and, importantly, legitimises and rationalises, violent coach behaviour such as physical force to stretch gymnasts, slapping, yelling, enforced training and training with pain, and emotional manipulation such as withdrawing attention during training (Pinheiro et al., 2012; Barker-­Ruchti  & Tinning, 2010). It is also this system of inequality that is argued to allow sexual violence (Fasting & Brackenridge, 2009). The values and (in)actions of others in the gymnastics context, including parents (see Young, 2013, cell 12, ‘parental abuse’), are also gendered. That is, because of gender norms and expectations, especially the positioning of parents (mostly mothers) as enablers of coaches’ directives, they may not recognise violent behaviours and, through acceptance, invalidate the violence their daughters experience (Smits et al., 2016; Ryan, 2000; see also Slater, 2012). A last example that we consider particularly gendered in WAG is Young’s (2013) cell 13, ‘sexism/racism’, and cell 14, ‘other identity violence’, which can be linked to the obligatory uniform, the leotard. Scholars argue that the leotard is a form of systemic sexism and oppression (e.g. Stewart et al., 2010; Lord & Stewart, 2020) which, by prescribing a narrow definition of femininity, has exclusory effects. Taken together, violence in WAG is common because it intricately intertwines with gender structures that are integral to the sport process. At present, we argue, the recognition of this intertwinement is only emerging. To extend this knowledge, we will in the following identify six material and cultural processes and conditions that facilitate sports-­related violence against 59

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gymnasts and describe how change to one widely accepted material condition in WAG, the leotard, has the potential to reduce the risk of violence against gymnasts.

Six gender ideologies that generate violence against gymnasts Based on the previous summary of sociocultural literature illustrating gender in WAG, we propose six elements that have, since the acrobatisation of WAG4 during the 1970s (Barker-­ Ruchti, 2009; Cervin, 2020a; Chisholm, 2002), become institutionalised: 1) the pre-­pubescent body ideal, 2) the imbalanced coach-­gymnast relationship, 3) the violent model of coaching, 4) sexualised movements and postures, 5) gymnastics materials, 6) the judging system. Considered from a gender structure theory perspective (Risman, 2018), the six elements create material and cultural processes and conditions that contribute to gender inequality and violence against gymnasts. Table 5.1 outlines the six elements and presents their underlying gender assumptions, the WAG practices these constitute, and the violence they create against gymnasts. The interactions between gender assumptions, WAG practices, and forms of violence are not limited to a horizontal cause–effect relationship within each element. Interaction also takes place vertically between the outlined WAG elements and intersectionally with social structures of age and prescribed social positions. The imbalanced coach–gymnast relationship element (element 2), for instance, strongly relates to the selection of genetically predisposed gymnasts and the practices listed under the violent model of coaching (element 3). Indeed coaches, because of their age and social position, are granted the authority to select gymnasts into WAG and out of WAG performance levels, training camps, and competitions (Kerr, 2020). Coaches are also the stakeholders that shape and lead a coaching environment (i.e. at a club or national training facility) and often act as the persons hiring coaches with pixie-­style coaching styles (Kerr, 2014; Kerr & Moore, 2015). As such, male or female coach authority significantly contributes to the various forms of coach violence against gymnasts. To further illustrate vertical interaction and intersectionality, in the judging system element (element 6), the normalisation of judge scrutiny interrelates with the leotard as a judging device, the argument being that body-­hugging clothes reveal gymnasts’ performance execution mistakes (Stewart et al., 2010). Lastly, in the sexualised movements and postures element (element 4), its underlying assumptions constitute this sport’s feminised movements and exercises, regulations, equipment, and clothing. Specifically, the interaction between a gymnast’s child-­like body, flirtatious movements in her competition exercises, and revealing leotard constitute an image of immaturity, purity, and innocence, which a number of scholars have argued, on the one hand, conceals gymnasts’ strength, proficiency, and effort of executing the often risky gymnastics exercises (Weber  & Barker-­Ruchti, 2012) and, on the other hand, is pornographic (Eagleman, Rodenberg & Lee, 2014; Haug, 1999). Wright (1991, p. 64) explains: Gymnasts are constructed as de-­sexualised sex-­objects, innocent of their own sexuality, but at the same time, producing sexualised performances that are available for public consumption. Moreover, the brilliance of technique, the breath-­taking achievements of the gymnasts may also seduce the reader/spectator into ignoring the gendered meanings that are simultaneously being constituted by and through the superb performances. As a result, the described interactions between all six WAG elements, in intersection with age and social position, objectify gymnasts. Coaches, in turn, are positioned as superior and in charge, which facilitates the (re)production of inequality and enactment of violence, which limits coaches’ abilities to resist such gender structures. 60

Violent model of coaching

- Training until coach satisfaction is reached - Physical contact, including forced stretching; striking, hitting or throwing items; repetition punishments - Name calling; yelling, criticising; belittling and humiliating - Emotional manipulation, including withdrawing attention and threatening - Restricted gymnasium access to family members

(Continued)

- Pain and shor t- and long-term injuries - Over training and burnout - Emotional pain and disorders - Pathological personal development - Isolation from caregivers and suppor t

- Submissiveness, dependence, and fragility - Lack of agency to develop independently - Sexual abuse

- Restriction and exclusion of childhood and children in spaces - Silencing of and disregard for puber ty - De-sexualisation of female body and identity development

- Encouragement of early entrance and specialisation - Selection of gymnasts with par ticular genetic predispositions and de-selection of gymnasts outgrowing the ideal - Restriction of dietar y intake and substance consumption (i.e. diuretics) - Coach monitoring and control per vades gymnasts’ lives - Paternal care and maternal discipline - Coach as gatekeeper to oppor tunities for success

Predicated on the female body’s maturation as complicating: - The female body has limited time to learn - A mature female body is biomechanically disadvantaged - The (mature) female body is excessive or ‘messy’ Predicated on spor t and spor ts coaching as masculine: - Male coaches as instructional technicians and disciplinar y agents - Male and female coaches as disciplinar y agents built upon male ideology - Coaches as exper ts to develop child athletes towards elite spor t success Predicated on the female body as unruly: - The young female body is malleable and open to manipulation - The female body must be disciplined

The pre-pubescent body ideal

The imbalanced coach–gymnast relationship

Violence against gymnasts

WAG practices

Gender ideologies

WAG elements

Table 5.1  The six WAG elements’ gender ideologies that constitute WAG practices and place gymnasts at risk of violence.*

Gendered violence in women’s gymnastics

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62

Gymnastics equipment – Predicated on the female body as less strong than the male body: - Spor t equipment must be adjusted to suit female physique and movement capacity The leotard – Predicated on the female body as an object of (visual) pleasure: - Clothing ser ves to decorate and reveal the female body

Predicated on the female body as an object of (formal) scrutiny: - Women are valued for their bodies, looks, and way of movement - The female body is an object of evaluative aesthetic gaze

Gymnastics materials

The judging system

- Regulations structure femininity (i.e. leotard rules, music for floor exercise, value of ar tistic movement skills) - Normalisation of formal sur veillance - Judging bias because of corporeal, appearance, and per formance norms

- Accentuation, normalisation, and maintenance of pre-pubescent body shape via v-cut shape and revealing of entire leg - Sur veillance of leotard compliance (includes hiding puber ty) - Justification of the leotard as a legitimate tool of sur veillance (e.g. reveals movement mistakes) - Hyper-feminisation of gymnast

- Regulations demand expressiveness, ar tistr y, and dance-type movements on balance beam and floor for female gymnasts - Use of music encourages choreographing of flirtatious, sensual, erotic, and sexually suggestive poses, especially on balance beam and floor - Normalisation of physical flexibility as an expected competence (i.e. splits) - Per formances aim to connect/flir t with audiences (i.e. smiling, dramatic movements) - Gendered and sexualised media representations (i.e. photographs of arched back, straddled legs) - Use of equipment is gendered, apparatus specifically for women to succeed - Equipment perpetuates aesthetic movement skills (i.e. balance on balance beam, dance skills on balance beam/floor)

(* The columns ‘gender ideologies’ and ‘WAG practices’ were inspired by Risman’s (2018) ‘gender structure theory’.)

Predicated on the female body as an object of (erotic) pleasure: - The female body moves naturally in aesthetic, sexual, and erotic ways - The female body is the object of others’ desire and pleasure, sexually attractive and seductive - The female body can be owned

Sexualised movements and postures

Table 5.1 (Continued)

- Self-sur veillance of body and associated disorders (i.e. eating disorders) - Reduction in corporal expression - Embodied discomfor t and distress associated with wearing the leotard, especially during puber ty - Heteronormative classification of gymnast population - Discrimination of perceived non-fitting bodies, looks, and movements (ideological violence, deprivation)

- Normalisation of gymnastics movements - Reduction of movement possibilities - Limitation of bodies produced

- Pornographising of gymnasts - Hiding of effor t, competence, and skill, esp. via playfulness - Narrow parameters of appearance, body shape, and corporal expression - Heteronormative classification of gymnast population

Barker-­Ruchti, Schubring and Stewart

Gendered violence in women’s gymnastics

How, then, may change be initiated to combat violence in WAG? In the following, we hypothesise how changing one material WAG element, the leotard, can disrupt the previously outlined material and cultural expectations and, through this, reduce the risk of violence against gymnasts. In the changes we hypothesise for the garment, we take particularly seriously Risman’s call for change in expectations attached to men and women.

Changing the leotard to reduce risk of gendered violence The leotard was originally developed by Frenchman Jules Leotard (1842–1870) (Lynch  & Strauss, 2015). Leotard was a trapeze artist and knitted what he called a ‘maillot’ (French for tight-­fitting clothing) to provide him with freedom of movement and a means to show off his muscular physique. After his death, Paris ballet schools adopted the maillot and, from 1886 onwards, it became known as a ‘leotard’. When leotards became used by women, the garment covering the crotch area was narrowed and the leg opening increased to ensure split-­leg performance functionality. Over time, the leotard became predominantly a woman’s garment in sport, fitness, entertainment, and business, and increasingly served the purpose of accentuating the female physique. To this end, we suggest that the leotard as an object simultaneously sets the stage for gender performance in gymnastics and is an integral part of it. In WAG, the leotard has been the competition attire since the 1940s (Meyers, 2016). Today, the sport’s rulebook, the Code of Points (Fédération Internationale de Gymnastique Women’s Technical Committee, 2016, p. 2.2, emphasis ours), prescribes competition clothing as follows: They [gymnasts] must wear a correct sportive non-­transparent leotard or unitard (one-­piece leotard with full length legs-­hip to ankle), which must be of elegant design. She may wear complete leg coverings of the same colour as that of the leotard; under or on top of the leotard. Gymnasts rarely wear a unitard; at least, the author team has only once seen this at televised competitions. Rather, gymnasts mostly dress in a long-­or short-­sleeved leotard, reaffirming rather than resisting the gendered structure materialised in the leotard. However, it is our contention that a unitard, or another gender-­neutral or even masculine-­connoted shape of leotard, could disrupt femininity expectations, as Risman (2018) proposes in gender structure theory. The addition of tight-­or loose-­fitting shorts or long pants, such as male gymnasts wear on pommel horse, rings, and the high bar, would, for one, add a greater range of dress options, which could offer gymnasts more room to choose what they would like to wear. Such a range of options would provide gymnasts at the individual level a choice in relation to preferred comfort, moods and circumstances (i.e. body exposure, body satisfaction, menstruation). This could reduce violence-­induced self-­scrutiny, discomfort, and distress and increase options for corporal expression, which can positively affect attitudes, perceived norms, and self-­efficacy. For two, a greater range of attire that is less sexualising may, at the interactional level, broaden the range of possible gymnastics expectations and representations. At present, the leotard is strongly associated with sexualised movements and poses arranged by coaches or choreographers. If gymnasts could choose from a range of clothing options, they (as coaches and choreographers) may increase the range of movements associated with the traditional leotard – the expected flirtatious, sensual, erotic, and sexually suggestive movements and poses. They may, for instance, adopt moves from other gymnastics disciplines (i.e. male gymnastics, aerobics) and contemporary dance, hip-­hop, or break dance. Such a change may reduce gymnasts’ feminisation and the normalisation of flexibility and, through this, emphasise gymnasts’ effort, competence, and strength. This change in clothing may affect the media in that images showing 63

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gymnasts with split legs will create different impressions (i.e. the vagina will be covered by more garment) (Weber  & Barker-­Ruchti, 2012). Last, as altered clothing may introduce different movement styles (i.e. less focus on traditional sensual/erotic movement and poses) and cover gymnasts’ crotch area, it could facilitate photographers to produce different images and sports journalists to speak/write about gymnasts’ performances in alternative ways. As a result, the change in gymnastics clothing as one key material condition of the violent WAG gender structure may position the gymnast less as a docile ‘pixie’ gymnast who is controlled and disciplined by a coach, scrutinised by judges, and gazed upon by audiences because of corporeal and erotic features. This re-­positioning of the gymnast has potential to empower and diffuse the gender of the gymnast which, we argue, would, at Risman’s social level of gender structure, disrupt the gendered expectations associated with female gymnasts. We acknowledge that our proposition to change the leotard is hypothetical, and for some maybe even utopian. Yet as Risman and colleagues (2012) argue, disrupting gender expectations at the utopian level is a suitable starting point to achieve social change. Such imagining of social change (e.g. changing the leotard) can provide or change ideas about gendered expectations. Indeed, Risman and colleagues (2012) see the step of creating ideas as key for communities and stakeholders to understand how material and cultural conditions and processes can be less gendered (or be gender neutral). Risman does, however, acknowledge that although change to one element can reverberate to/between the individual, interactional, and social levels, for change to become reality, “institutions and their cultural meaning systems have to be transformed with a vision of gender neutrality” (Risman, Lorber & Sherwood, 2012, p. 23). So, while the changes we propose to the leotard have potential to impact gender as a social structure at the individual, interactional, and social levels of cultural and material conditions and processes, WAG organisations must intervene in order to permanently impact the traditional expectation of docile pixie-­ gymnast. Only then, according to Risman, is the change likely to allow gymnasts to develop into empowered individuals who can shape their interactions with stakeholders, and coach(es) particularly, and through this reject violent coach behaviour (for a similar argument, see Barker-­ Ruchti, Kerr, Schubring, Cervin & Nunomura, 2017). If WAG organisations take a role in and responsibility for being more critical towards gendered expectations and creating more gender-­ neutral sporting environments, then gymnasts’ risk of being exposed to violence could be reduced.

Conclusion In this chapter, we have aimed to show how viewing violence as contextually driven behaviours and gender as socially constructed can help better recognise, explain, and potentially transform the violence that gymnasts experience. Aligned with scholars who view gender as a structure or system of inequality embedded in all aspects of society and not in binary or individual categorical terms, we reveal insights into some of the gender ideologies and relations of power that underpin and govern gymnastics at individual, interactional, and social levels. Violence in gymnastics, we have demonstrated, is historically and socially constructed and culturally produced through structures of gender – a connection that has received little attention to date. Demonstrating these social and procedural connections is important because they: 1) demonstrate the broad nature of violence; 2) highlight the interconnections between sexual and other forms of violence; 3) reveal structures of gender that normalise increased levels of violence towards girls and women; 4) challenge the assumption that gender inequalities occur at the level of the individual, which can be easily eliminated with opportunity in sport; and 5) recognise the intersections of gender with, for example, sexuality, class, ‘race’, and ethnicity. On this last point, we acknowledge the pervasive and powerful influence of whiteness on our analyses of gymnastics 64

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in this chapter and encourage future gender scholars to focus upon how gender interacts with other kinds of privilege and inequality. This said, we hope that our illustration is a pragmatic starting point for generating a broader dialogue on more intersectional understandings of gender that relate to the welfare of individuals in sport more generally. We invite researchers and sport stakeholders to use Table 5.1 as a tool to initiate discussions and map gender assumptions, structures/practices, and consequences within and across a range of specific sport settings to identify how violence might manifest and in what forms. In particular, we invite stakeholders to play with the elements at the different levels to identify transferable mechanisms that create or challenge inequality and to examine potential points of disruption to gender and other structures of inequality within their roles or organisations. Risman (2018, p. 38) reminds us that “change is fluid and reverberates throughout the structure dynamically”, such that changes in cultural expectations shape individual identities and vice versa. Likewise, institutional changes across time and space can reverberate at the level of culture and individual identities. Drawing our discussion back to WAG, we have illustrated the need to identify enactments related to taken-­for-­g ranted gendered cultural norms and offered opportunities for individuals, groups, and – importantly – organisations to ‘do’ gender consciously to disrupt practices that often lead to violence.

Notes 1 The USA Gymnastics sex abuse scandal became public in September 2016 when Rachael Denhollander and another former gymnast accused Larry Nassar of sexual abuse (Evans, Alesia & Kwiatkowski, 2018). Since then, more than 250 women and girls have come forward with similar accusations. The trials (at both federal and county levels) found Nassar guilty of multiple sexual assault, abuse, and child pornography charges, which resulted in a prison sentence of 60 years (federal level) and 40 to 175 years (state level). In the aftermath of Nassar’s sentencing, lawsuits against Michigan State University, the US Olympic Committee, USA Gymnastics, and the Twistars Gymnastics Club have been filed by former gymnasts and athletes. 2 We acknowledge that a number of international institutions provide definitions of gendered violence, particularly through the term gender-­based violence (GBV). Important texts include the United Nations General Assembly (1993) Declaration on the Elimination of Violence against Women; Bloom’s (2008) report ‘Violence against women and girls: A compendium of monitoring and evaluation indicators’; the European Union’s Directive (2012) establishing minimum standards on the rights, support, and protection of victims of crime, which includes GBV; the European Institute for Gender Equality’s (EIGE) (2012) ‘Gender Equality Index’; and the recent report ‘Study on Gender-­Based Violence in Sport: Final Report’, conducted by Mergaert, Arnaut, Vertommen and Lang (2016). 3 Young (2008, p.  174) broadly defines SRV as to “include aggressive, threatening, harmful or otherwise unjust practices enacted within the context of sport”. The 18 formations of violence (or cells) he includes are: 1. Crowd violence; 2. Player violence; 3. Individualised fan–player violence; 4. Player violence away from the game; 5. Dangerous masculinities/street crimes; 6. Women, aggression, and violence; 7. Violence against the self; 8. Athlete hazing/initiation; 9. Harassment, stalking, and threat; 10. Sexual assault against adults and children; 11. Partner abuse; 12. Offences by coaches/administrators; 13. Parental abuse; 14. ‘Blood’ and animal sports; 15. Political violence/terrorism; 16. Racism; 17. Crimes against workers and the public; 18. Crimes against the environment. 4 By acrobatisation, we refer to WAG’s transformation from a callisthenic-­and ballet-­type to a high-­risk acrobatic activity during the late 1960s and 1970s (Barker-­Ruchti, 2009). The earlier form of gymnastics included few aerial movements; the later form demands different forms of somersaults and circus-­type movements.

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Barker-­Ruchti, N., Kerr, R., Schubring, A., Cervin, G.  & Nunomura, M. (2017). “Gymnasts are like wine, they get better with age”: Becoming and developing adult women’s artistic gymnasts. Quest, 69(3), 348–365. Barker-­Ruchti, N. & Tinning, R. (2010). Foucault in leotards: Corporal discipline and coaching practice in women’s artistic gymnastics. Sociology of Sport Journal, 27(3), 229–250. Bloom, S. S. (2008). Violence against women and girls: A compendium of monitoring and evaluation indicators. Retrieved from: www.measureevaluation.org/resources/publications/ms-­08-­30 Cervin, G. (2020a). Acrobatisation and establishment of pixie-­style WAG. In Kerr, R., Barker-­Ruchti, N., Kerr, G. A. & Stewart, C. (Eds.), Women’s artistic gymnastics: Socio-­cultural perspectives. London: Routledge. Cervin, G. (2020b). Perfectionisation of WAG. In Kerr, R., Barker-­Ruchti, N., Kerr, G. A. & Stewart, C. (Eds.), Women’s artistic gymnastics: Socio-­cultural perspectives. London: Routledge. Chisholm, A. (2002). Acrobats, contortionists, and cute children: The promise and perversity of U.S. women’s gymnastics. Signs: Journal of Women in Culture and Society, 27(2), 415–450. Deutsch, F. M. (2007). Undoing gender. Gender and Society, 21(1), 106–127. Eagleman, A. N., Rodenberg, R. M. & Lee, S. (2014). From “hollow-­eyed pixies” to “team of adults”: Media portrayals of Olympic women’s gymnastics before and after an increased minimum age policy. Qualitative Research in Sport, Exercise and Health, 6(3), 401–421. European Institute for Gender Equality (2012). Gender equality index. Retrieved from: http://eige.europa. eu/gender-­statistics/gender-­equality-­index European Parliament and the Council of the European Union (2012). Directive 2012/29/EU of the European Parliament and of the Council of October 25, 2012 establishing minimum standards on the rights, support and protection of victims of crime, and replacing Council Framework Decision 2001/220/JHA. Retrieved from: https://eur-­lex.europa.eu/legal-­content/EN/TXT/PDF/?uri=CELEX:32012L0029&from=EN Evans, T., Alesia, M. & Kwiatkowski, M. (2018). Former USA gymnastics doctor accused of abuse. IndyStar. Retrieved from: https://eu.indystar.com/story/news/2016/09/12/former-­usa-­gymnastics-­doctor­accused-­abuse/89995734/ Fasting, K. & Brackenridge, C. (2009). Coaches, sexual harassment and education. Sport, Education and Society, 14(1), 21–35. Fédération Internationale de Gymnastique Women’s Technical Committee (2016). 2017–2020 code of points: Women’s artistic gymnastics. Lausanne: International Federation of Gymnastics. Gertsch, C.  & Steffen, B. (2015). Ariella Kaeslin  – Leiden im Licht. Die wahre Geschichte einer Turnerin. Zürich: Neue Zürcher Zeitung. Gervis, M. & Dunn, N. (2004). The emotional abuse of elite child athletes by their coaches. Child Abuse Review, 13(3), 215–223. Haug, F. (1999). Notes on women’s gymnastics. In Haug, F. (Ed.), Female sexualisation: A collective work of memory (pp. 177–184). London: Verso Books. Hudson, M. (1995, April 2). Romanian gymnast’s murder puts negative light on sport. Los Angeles Times, p. 5D. Jacobs, F., Smits, F. & Knoppers, A. (2016). “You don’t realise what you see!”: The institutional context of emotional abuse in elite youth sport. Sport in Society, 20(1), 126–143. Jakobsen, H. (2014). What’s gendered about gender-­based violence? An empirically grounded theoretical exploration from Tanzania. Gender and Society, 28(4), 537–561. Kerr, R. (2014). From Foucault to Latour: Gymnastics training as a socio-­technical network. Sociology of Sport Journal, 31(1), 85–101. Kerr, R. (2020). The sorting of gymnasts: An actor-­network theory approach to examining talent identification and development in WAG in New Zealand. In Kerr, R., Barker-­Ruchti, N., Kerr, G. A. & Stewart, C. (Eds.), Women’s artistic gymnastics: Socio-­cultural perspectives. London: Routledge. Kerr, R., Barker-­Ruchti, N., Schubring, A., Cervin, G.  & Nunomura, M. (2019). Coming of age: Coaches transforming the pixie-­style model of coaching in women’s artistic gymnastics. Sports Coaching Review, 1–18. Kerr, R.  & Cervin, G. (2016). An ironic imbalance: Coaching opportunities and gender in women’s artistic gymnastics in Australia and New Zealand. The International Journal of the History of Sport, 33(17), 2139–2152. 66

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Kerr, R. & Moore, K. (2015). Hard work or child’s play? Migrant coaches’ reflections on coaching gymnastics in New Zealand. World Leisure Journal, 57(3), 185–195. Lord, R. & Stewart, C. (2020). Trampoline gymnasts’ body-­self narratives of the leotard: A seamless fit? In Kerr, R., Barker-­Ruchti, N., Kerr, G. A. & Stewart, C. (Eds.), Women’s artistic gymnastics: Socio-­cultural perspectives. London: Routledge. Lynch, A. & Strauss, M. D. (Eds.). (2015). Ethnic dress in the United States: A cultural encyclopedia. Lanham: Rowman & Littlefield. Mergaert, L., Arnaut, C., Vertommen, T. & Lang, M. (2016). Study on gender-­based violence in sport: Final report. Report for the European Commission Education, Audiovisual and Culture Executive Agency. Retrieved from: www.ec.europa.eu/sport/sites/sport/files/gender-­based-­violence-­sport-­study-­2016_en.pdf Meyers, D. (2016, 27 June). The complete evolution of the gymnastics leotard from the 1930s to today: Granny cuts to bedazzled bodysuits. Elle. Retrieved from: www.elle.com/fashion/a37371/ evolution-­of-­gymnastics-­leotard/ Olaru, M. (2016). Pretul aurului: Sinceritate incomoda (Trans. The price of gold: Uncomfortable sincerity). Bucharest: Editura Vremea Bucureşti. Pinheiro, M. C., Pimenta, N., Resende, R. & Malcolm, D. (2012). Gymnastics and child abuse: An analysis of former international Portuguese female artistic gymnasts. Sport, Education and Society, 19(4), 435–450. Prinz, R. (1999). Notes on women’s gymnastics. In Haug, F. et al. (Eds.), Female sexualisation: A collective work of memory (Trans. E. Carter) (pp. 176–183). London: Verso Books. Risman, B. J. (2004). Gender as a social structure: Theory wrestling with activism. Gender and Society, 4(18), 429–450. Risman, B. J. (2018). Gender as social structure. In Risman, B., Froyum, C. & Scarborough, W. J. (Eds.), Handbook of the sociology of gender (pp. 19–43). New York: Springer. Risman, B. J., Lorber, J. & Sherwood, J. H. (2012). Toward a world beyond gender: A utopian vision. Paper presented at the 2012 American Sociology Society Meeting, Denver, Colorado, USA. Ryan, J. (2000). Little girls in pretty boxes: The making and breaking of elite gymnasts and figure skaters. New York: Warner. Schubring, A. & Thiel, A. (2016). Health-­related gender boundary crossing in youth elite sport. Sport in Society, 19(5), 695–710. Slater, M. (2012). Invalidation: A neglected dimension of gender-­based violence and inequality. International Journal for Crime, Justice and Social Democracy, 1(1), 3–13. Smits, F., Jacobs, F. & Knoppers, A. (2016). “Everything revolves around gymnastics”: Athletes and parents make sense of elite youth sport. Sport in Society, 20(1), 66–83. Stewart, C. (2018). Utilising sporting autobiographies for feminist research: The case of cyclist Nicole Cooke. In Mansfield, L., Caudwell, J., Wheaton, B. & Watson, B. (Eds.), The Palgrave handbook of feminism and sport, leisure and physical education (pp. 293–311). London: Palgrave MacMillan. Stewart, C., Barker-­Ruchti, N. & Schubring, A. (2018). Let’s talk about gender-­based violence and gymnastics. Paper presented at the World Congress of Sociology of Sport, Lausanne, Switzerland. Stewart, C., Lord, R., Wiltshire, G. & Fleming, S. (2010). Ease of movement and freedom of corporeal expression? Femininity, the body and leotards in trampoline gymnastics. Leisure Studies Association, 110, 63–76. Stier, J. (2012). Blod, svett och tårar: Ledarkulturen inom Svensk landslagsgymnastik – belyst och problematiserad (Trans. Blood, sweat and tears: Leadership culture within Swedish national team gymnastics – highlighted and problematised). Retrieved from: www.diva-­portal.org/smash/get/diva2:608633/FULLTEXT01.pdf Stirling, A. E. & Kerr, G. A. (2013). The perceived effects of elite athletes’ experiences of emotional abuse in the coach-­athlete relationship. International Journal of Sport and Exercise Psychology, 11(1), 87–100. Theberge, N. (1993). The construction of gender in sport: Women, coaching, and the naturalisation of difference. Social Problems, 40(3), 301–313. United Nations General Assembly (1993). UN declaration on the elimination of violence against women. Retrieved from: www.un.org/documents/ga/res/48/a48r104.htm Varney, W. (1999). Legitimation and limitations: How the Opie report on women’s gymnastics missed its mark. Sporting Traditions, 15(2), 73–90. 67

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6 Psychological abuse in competitive and high-­performance women’s volleyball Alixandra Krahn

Introduction The coach–athlete relationship is a major part of the sport experience for most athletes (Brackenridge & Fasting, 2005; Jowett & Cockerill, 2003; Stirling & Kerr, 2014). Within the competitive/high-­performance1 sport context, coaches and athletes interact on a day-­ to-­day basis, and these interactions often inform the growth and direction of the athlete as a ‘pupil’ of the coach. Many studies indicate that such a relationship is one of high interdependence, where the coach occupies the more dominant role and the athlete the more submissive role (Barker-­Ruchti  & Tinning, 2010; Brackenridge  & Fasting, 2002; Kirby, Greaves & Hankivsky, 2000; Lang, 2010; Parent & Bannon, 2011; Stirling & Kerr, 2009; Tomlinson  & Yorganci, 1997). This creates a situation where the coach has a profound ability to impact the athlete’s life, both in the short and long term (Gervis & Dunn, 2004; Stirling & Kerr, 2009). Research further suggests that a breakdown within the coach–athlete relationship often results in a negative sporting experience, which may impact athlete welfare (Brackenridge & Fasting, 2002; Jowett, 2007; Jowett & Cockerill, 2003; Stirling & Kerr, 2009, 2014). One of the ways in which a breakdown can occur within the coach–athlete relationship is as a result of some form of abusive coach behaviour, which is often linked to the undermining of the athlete’s autonomy by the coach (Brackenridge & Fasting, 2002). Abuse in sport can take many forms, ranging from physical and sexual abuse to psychological abuse. With the majority of research focusing on the more overt forms of abuse (e.g. sexual abuse), there remains a need to critically discuss more covert or nuanced forms of abuse (e.g. verbal and psychological). In response to this need, this chapter will unpack how verbal psychological abuse is understood by coaches and the impact that this form of abuse may have on the welfare of competitive/high-­performance female athletes. In this chapter, I will outline current definitions of psychological abuse, review the research on psychological abuse (and, where available, verbal psychological abuse) within the Canadian sport landscape, and share the views of eight competitive/high-­performance women’s volleyball coaches on verbal forms of psychological abuse.

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Verbal forms of psychological abuse in competitive and high-­performance sport It is well documented in the literature that some competitive sport coaches adopt abusive coaching practices (i.e. Baker, Côté & Hawes, 2000; Brackenridge & Fasting, 2005; Kirby et al., 2000; Parent & Bannon, 2011; Stirling, 2008; Stirling & Kerr, 2008a, 2009, 2012, 2014; Tomlinson & Yorganci, 1997). As previously stated, the emphasis has remained on sexual abuse (e.g. the Canadian women’s Alpine Ski sex abuse scandal)2, while psychological abuse remains under-­ examined. Literature that defines or includes verbal forms of psychological abuse specifically is sparse. Rather, verbal abuse is referred to as a part of psychological abuse in the literature. The lack of literature on psychological abuse and verbal forms of this has been identified a result of: 1) societal acceptance of psychological abuse (i.e. normalisation), 2) the unclear intent of the perpetrator (i.e. intended versus unintended forms of abuse), and 3) a limited perceived view of potential interventions (i.e. understanding how to intervene) (Brassard  & Donovan, 2006). Additionally, Iwaniec (2003) identifies the lack of focus on psychological abuse as a result of the contention in defining this form of abuse, which has further impacted the identification of psychologically abusive coaching behaviours and thus prevention and intervention within competitive/high-­performance sport. Furthermore, researchers’ understandings of psychological abuse from a coach’s perspective are preliminary in nature; most studies attempting to define psychological abuse report on athletes’ perceptions rather than coaches’ (Gervis & Dunn, 2004; Stirling & Kerr, 2008a, 2012, 2014). Attempts to define psychological abuse exist within a range of research areas (e.g. Glaser, 2002; Iwaniec, Larkin & Higgins, 2006; O’Hagan, 1995); however, very few have been contextualised within the high-­performance sport setting or the coach–athlete relationship (Stirling, 2008; Stirling & Kerr, 2008a, 2012, 2014). Defining psychological abuse in sport has been recognised as a struggle in the coaching and sport psychology literature for a number of years, and as a result, there is no consistent definition of psychological abuse applied in the research literature, in coaching education resources, in coaching policies, or in practice. Brassard and Donovan (2006) speculate that this inconsistency is because of a variety of societal factors, as previously identified. Furthermore, it is critical to acknowledge that the lived subjective experience of abuse (i.e. athletes’ experiences of coach abuse) and objective definitions of abuse (see, for example, Lang, Rulofs & Hartill, 2016) contribute to the tension that surrounds defining abuse broadly and psychological abuse specifically. For example, explicitly defining psychological abuse does not acknowledge the range of athlete experiences of abuse (e.g. some athletes may find being yelled at motivating and contributing to their performance, while others may find it unhelpful and having a negative impact on their performance). However, without a definition of psychological abuse, addressing and policing abusive coach behaviours is challenging. In order to provide clarity for readers, the remainder of this chapter will adopt the definition of emotional abuse from the work of Stirling and Kerr (2008a, p. 178), which is: a pattern of deliberate non-­contact behaviour by a person within a critical relationship role that has the potential to be harmful. Acts of emotional abuse include physical behaviours, verbal behaviours, and acts of denying attention and support. In addition to being contextualised within the literature on Canadian competitive and high-­ performance sport, Stirling and Kerr’s (2008a) research specifically discusses verbal forms of psychological abuse. 70

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Another relevant study explored the considerable amount of pressure on athletes and coaches to win in competitive sport and the impact that this pervasive performance narrative has on rationalising certain abusive coaching behaviours (Gervis & Dunn, 2004). Specifically, this study explored verbal forms of psychologically abusive coaching practices as a function of a ‘win-­at-­ all-­costs’ mentality adopted by the coach; Gervis and Dunn (2004, p. 216) state, “[i]n sport, the end, namely winning, often justifies the means”. This mentality – that winning is all that matters – aligns with Ryan’s (1995) investigation that reported winning as all that is recognised within the athletic arena. Other factors that have been noted in the literature as contributing to the psychological abuse of athletes include prolonged periods of time spent with the coach, the high degree of interdependence of the athlete on the expertise of the coach, a coach’s style of coaching (i.e. autocratic or athlete-­centred), and gender power relations (Crosset, 1986; MacAuley, 1996; Stirling, 2008; Stirling  & Kerr, 2007, 2009, 2012; Tomlinson  & Yorganci, 1997). It is clear from the results of these studies that not only are some athletes experiencing psychological abuse at a young age but that this abuse continues to impact them long term. For example, athletes may experience withdrawal from sport altogether, drastic changes in mood, lowered self-­efficacy, and disordered eating, to name a few issues (Stirling & Kerr, 2008b). As such, these kinds of coaching behaviours have the potential to profoundly impact athletes’ experiences both within and outside of the competitive/high-­performance sport environments and further call into question the role of the coach within this sporting context.

Psychological abuse within the Canadian sport landscape Canadian sources analysing the psychological abuse of athletes by coaches date back to the mid-­ 1990s, when the abuse of athletes was brought to the forefront of competitive sport as a major concern. Specifically, within Canada, this began with the release of the Fifth Estate3 programme by the Canadian Broadcasting Corporation (CBC) in 1993 called ‘Crossing the Line’, which explored examples of the sexual abuse of female athletes by male coaches on two university volleyball teams, a swim team, and a rowing team. Following this investigative report, in 1996, ice hockey coach Graham James was convicted of repeated counts of sexual abuse against Sheldon Kennedy, a player James had coached in the National Hockey League (Donnelly, Kerr, Heron & DiCarlo, 2014). In addition to the conviction of James, the Fifth Estate programme contributed to the realisation that sexual abuse in sport is a serious reality (Brackenridge, 2001), further highlighting the need to re-­examine harassment in sport policies and encourage further research on all forms of abuse in sport (Donnelly et al., 2014; Kirby & Greaves, 1996; MacGregor, 1998). In response to the nationwide broadcast of ‘Crossing the Line’, the high-­profile James case, and the sudden recognition about the reality of (sexual) abuse in high-­performance sport, several policies were created and adopted in Canada. In the early 1990s, the assistant deputy minister of sport formed a ‘harassment in sport’ working group, composed of members from a variety of sport governing bodies. The most immediate policy responses from this group were the 1994 position statement ‘Harassment in Sport: A Guide to Policies, Procedures and Resources’, published by the Canadian Association for the Advancement of Women in Sport and Physical Activity (CAAWS), and the requirement that provincial sport organisations (PSOs) and national sport organisations (NSOs) appoint harassment officers (Donnelly et al., 2014). During the 1990s, there was an increase in research on the rates of sexual, physical, and psychological abuse in Canadian sport (e.g. Holman, 1995; Kirby & Greaves, 1996; MacGregor, 1998). Not only did these initial studies on the prevalence of psychological abuse in the context of Canadian high-­performance sport establish this form of abuse as an ongoing issue that 71

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likely predated the 1990s, they also suggested that athletes’ experiences of psychological abuse by coaches required further investigation. Although considerable research dedicated to further understanding the role of abuse in sport in the early 2000s certainly had an impact, the 2014 conclusion from Donnelly and colleagues (2014, p. 12) is disconcerting: almost 20 years after harassment policies and harassment officers were mandated in provincial and NSOs in Canada, many are failing to meet policy requirements. This article also highlighted that where policies have been adopted by sports organisations, it is not always the case that clear definitions and examples of what constitutes abuse are included, which makes comprehension of the current policies difficult. These failings have been cited as contributing to the underreporting of coach abuse by athletes,4 resulting in few formal investigations into athlete abuse and a current culture of competitive and high-­performance Canadian sport where certain coach behaviours, including psychological abuse, are normalised (CBC, 2019; Kirby et al., 2000). Stirling and Kerr (2012) highlight that adults, as coaches and teachers, play a crucial role in guiding young individuals with limited life experience and knowledge towards achievement. As such, it is particularly important to examine coaches’ understandings of how specific coach practices may impact athlete welfare.

Canadian coaches’ views on verbal forms of psychological abuse This section of the chapter contributes the insights of eight competitive and high-­performance sport coaches.5 Specifically, three female and five male coaches between the ages of 30 and 65 from Canada participated in the study. All of the coaches had over 10 years of experience coaching competitive/high-­performance women’s volleyball. Additionally, almost all of the coaches that participated in the study were further recognised as key stakeholders within the province’s volleyball community given their significant involvement within their sport’s PSO. Finally, all of the coaches were at one point competitive or high-­performance athletes and, as such, often drew on experiences from their own athlete past in response to interview questions. When asked to discuss their definitions of ‘verbal abuse’, all of the participant coaches acknowledged the personal attacking of an athlete as a form of this. Many of their responses included comments about things outside of the athlete’s control (i.e. their physical appearance) the verbal threatening or attacking of an athlete for improper skill execution or questioning an athlete’s character based on their physical capabilities. Coaches also gave explicit examples of what verbal forms of psychological abuse might include or sound like, which for most of the participant coaches was based on their own experiences as high-­level athletes. For example, two coaches who played for a Canadian national team stated that verbal psychological abuse includes: When a coach is telling you, ‘you are a waste of space’, ‘you are stupid’, ‘you’ll never be anything’, ‘you don’t have a sniff’, ‘you’re a fucking bitch’, or that ‘I just can’t waste any more time with you’. When a coach says, ‘are you stupid?’, ‘are you a fucking retard?’ . . . or ‘you could jump higher if you weren’t so heavy’. Responses from coaches who did not have experience playing at the highest level of volleyball in Canada also included making hurtful comments on an ongoing basis and frequent comments about things that were not specific or relevant to a player’s athletic performance (i.e. 72

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body shaming or questioning an athlete’s intelligence). Taken together, the responses from the coaches indicated that they regard verbal psychological abuse as including words spoken directly to an athlete that are personal in nature and unrelated to sport and that these words may be abusive based on the content of the feedback delivered (i.e. demeaning comments) or on the style of delivery (i.e. angrily screaming as a means to communicate information or feedback). While keeping their personal definition of verbal psychological abuse in mind, coaches were then asked to define psychological abuse.6 Although many acknowledged it was hard to define, the coaches’ attempts to define psychological abuse included comments with respect to patterned forms of coach behaviour (i.e. picking on one player), using mind games to manipulate athletes, and coaches making athletes believe they are worthless. Some of the definitions coaches provided included: you know, consistent behaviours that belittle that individual either directly or within the group and, therefore, it could extend beyond verbal comments to including another sort of treatment or exclusion of a player from activity. knowing that person doesn’t like something and then putting them in the situation on purpose to try and enact change, or controlling a person saying one thing to them and then showing a different behaviour to them. repetitively devaluing somebody or . . . pointing out faults or flaws or mistakes . . . something deliberate, hurtful . . . doing something for a purpose, doing something to make a point . . . putting them in a situation where they are highly unlikely to be successful, and that’s your intended outcome. Furthermore, coaches considered the following behaviours to constitute forms of psychological abuse: threats (i.e. to revoke playing time or scholarship funds), not following through on what a coach said they were going to do (i.e. not starting an athlete who was promised to start), and spreading rumours about an athlete within the team (i.e. telling one athlete something about another athlete in order to create tension). These findings add further weight to the literature that suggests that psychological abuse can include non-­physical behaviours, including verbal attacks, by a coach (Gervis & Dunn, 2004; Stirling & Kerr, 2008a, 2012, 2014). Additionally, participants in this study added that psychological abuse could also be non-­verbal (e.g. ignoring an athlete on a regular basis in the training environment). After discussing coaches’ perceptions of both verbal forms of psychological abuse and psychological abuse, coaches were further asked whether they felt these were similar or distinct from one another. The coaches in this study discussed how grouping verbal behaviours and psychological abuse together is a common occurrence given that they can have similar effects on athletes. For example, two participants commented that: mind games about ‘you’ll start if you do this’, ‘you’ll start if you do that’. . . . Or saying, ‘if you don’t do 100 reps in the weight room, you’ll lose your scholarship’. . . . I think manipulating situations where a person can’t win. Sort of spirit breaking . . . could be both. I guess maybe even ignoring a person could amount to mental abuse. These answers are in line with and confirm Stirling and Kerr’s (2008a, 2014) findings that emotional abuse may be the result of physical and/or verbal behaviours as well as neglect. Participant coaches from the present study also acknowledged that part of the difficulty in defining 73

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psychological abuse is linked to an athletes’ perception of circumstances or exhibited coach behaviours that may be considered abusive. In addition, the coaches noted that these athlete perceptions may be linked to the immediate environment that athletes were raised in (i.e. their home life) or the nationality of the athlete. In the case of an athlete’s nationality, coaches mentioned how in different parts of the world, athletes were conditioned to accept varying degrees of coach abuse that, in Canada, may be perceived as unacceptable. For example, one coach commented on witnessing an athlete being slapped in the face by a coach and another coach recalled witnessing the “verbal undressing” of an athlete where he recalled thinking “that would never be allowed in Canada”. According to the coaches in this study, the impact of psychological abuse is heavily dependent upon the recipient and the context within which abusive behaviours manifest. Most of the coaches interviewed acknowledged the importance of the athlete perspective in potentially abusive situations. The coaches suggested that athletes’ reactions to statements had an impact whether or not comments are perceived as psychologically abusive and that the high degree of subjectivity is another contributing factor to the difficulty of defining psychological abuse. I’m sure there have been moments where athletes believed they’ve been verbally abused and they haven’t! Or mentally abused and they haven’t! . . . there’s always the perception like, where someone feels that feeling result, but you’re not in any way meaning for it to be that . . . So that one player’s take on it was that coach was abusing me. He picked on me. . . . That’s not abuse. But you feel it’s abuse so then it’s abuse to you. These comments from coaches indicate that the difficulties in defining psychological abuse, as highlighted in the literature, are legitimate (Glaser, 2002; Iwaniec et al., 2006; O’Hagan, 1995; Stirling & Kerr, 2008b). However, there was consensus that psychological abuse results from actions taken against individuals that elicit certain emotional responses from each individual athlete. All of the coaches acknowledged that verbal forms of abuse and psychological abuse were present in their specific sport contexts. Comments about the prevalence of abuse were predominantly recorded as very prevalent or not as prevalent as some may think. Participants’ answers were contextualised to their sporting environments. For example, coaches who felt that this abuse was prevalent discussed the pressure on high-­performance sport coaches to produce winning results and as occurring more often outside of Canada. When participants were asked to further comment on why they felt verbal forms of abuse and psychological abuse were prevalent in high-­level female volleyball, their responses varied. Specifically, these coach responses ranged from the deep-­seated historical roots of abusive coaching in competitive and high-­performance sport (Holman, 1995; Kirby & Greaves, 1996; Kirby et al., 2000) to more universal comments around poor management. For example, one participant said: You know certain coaches that’ve gotten away with it forever, why would they change? One, they’ve been successful. Two, they’ve been supported. Three, no one’s asked them to change [laughs]. Why would they change? This response and others like it lend support to the literature on coaching styles (e.g. autocratic versus athletic-­centred) (Gervis & Dunn, 2004; Kenow & William, 1999; see also Joseph Gurgis, Gretchen Kerr, and Ashley Stirling’s chapter on coaching styles in this compilation), the processes involved in normalising abusive coaching behaviours (Stirling & Kerr, 2007, 2008ab, 74

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2012), and the wider systemic issues pertaining to the high-­performance sport experience (Tomlinson & Yorganci, 1997). Coaches who thought abuse was less prevalent contextualised their answers to the Canadian sport landscape. For example, one coach with international experience said: I think it’s probably less prevalent in Canada than in a majority of other countries in the world. But I think it exists. . . . I see numerous examples of it. When asked to further comment on why they believed this form of abuse may not be as prevalent in Canada as elsewhere (although CBC’s [2019] investigative report would suggest otherwise), coaches felt that this was indicative of having a better connection to or a stronger relationship with an athlete. These answers reinforce the importance of a coach–athlete relationship and the need to further research this relationship (Jowett & Cockerill, 2003; Kenow & Williams, 1999; Lafrenière, Jowett, Vallerand  & Carbonneau, 2011; Stirling  & Kerr, 2009). Finally, coaches also felt that abuse was less common in sporting environments where there was less pressure to win. It is clear that coaches acknowledged the presence of psychological abuse, including verbal forms of this, within high-­level volleyball. Most of the coaches also recognised that not enough is done to address psychologically abusive coaching practices within Canada. These responses from coaches were particularly unsettling. For example, one participant said: I’ll use this analogy. When a dog goes into a playground and bites a child, we put the dog down. We don’t ask questions. We don’t give the dog a second chance. We don’t put the dog into another playground. We . . . have coaches that abuse, degrade . . . whether it’s emotionally, sexually, verbally . . . and we give them another chance. We get them another team, another set of athletes. We put them in another gym! As a part of the conversation on preventing psychological abuse in all its forms, coaches were asked to comment on how their coach education addressed abusive coaching. All but one coach felt strongly that coach education (e.g. the Respect in Sport [RIS]7 and Make Ethical Decisions [MED]8 modules) did little to address psychological abuse in sport and was ineffective in its purpose of educating coaches on contentious sport situations and ways in which to act morally in these situations. Some of the coaches’ comments included: It’s just more like a hoop to jump through. RIS training makes it safe for organisations. . . . Every coach in my club has taken Respect in Sport so, ‘hey man, the fact that they’re abusing them, I did all that I could’ . . . it’s just, it’s almost a green card for organisations to not get tagged . . . when something goes wrong. These responses from coaches unfortunately contradict the statement made on the Coaching Association of Canada’s (CAC) website, which states that, “by successfully completing the NCCP Make Ethical Decisions training, coaches will be fully equipped to handle ethical situations with confidence and surety” (CAC, 2019, para. 2). Additionally, according to these coaches, RIS training does not help coaches to identify and deal with abuse, harassment, neglect, and bullying in sport (Sport Manitoba, 2019, para. 1). A final set of questions linked to preventing psychological abuse touched on policy. These questions were posed to coaches in order to assess the availability, awareness, and overall 75

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effectiveness of sport policies on abuse within this specific high-­performance sporting environment. In the case of this study, five of the eight participants were unaware of any policy on psychological abuse, which was startling given that all of the coaches interviewed for this study were key stakeholders within their sport and coaching environments. The coaches that were aware of policies on abuse were actively coaching in university sport and made comments like: when there’s policy in place it’s fluff and . . . and ‘the curtain over the rabbit in the hat’ . . . it doesn’t matter. While these coaches may have some knowledge about policies on psychological abuse, these policies did not appear to matter, as they were not taken seriously in preventing harmful coach behaviours. This response supports the finding from Donnelly et al. (2014) that the sport governing bodies, and by extension their policies, are failing to address psychological abuse. The results from this study confirmed that coaches were aware of what coach behaviours are considered verbally psychologically abusive and that verbal forms of psychological abuse and psychological abuse more broadly could be a concern for some athletes within this specific high-­performance sport context. The participant coaches identified a variety of reasons for why this may be the case, including the demands of high-­performance sport and the lack of intervention from governing authorities present within this community, as well as ineffective education and policy. These responses from coaches contribute to rationalising this form of maltreatment as a part of the competitive/high-­performance sport experience, which is in line with other studies that have documented the normalisation of psychological abuse broadly within the culture of high-­performance sport (Lang et al., 2016; Stirling & Kerr, 2009, 2012, 2014; Stirling, 2008).

Final remarks I think it’s awful the number of abused women that have come out of this province over the last 40 years that we know about. It’s awful and we continue to allow that to happen. Maybe not in the same quantities, but it’s happening. It absolutely is!

This quote from a coach participating in this study highlights her beliefs on both the current and past existence of psychological abuse within the context of this specific competitive/high-­ performance female volleyball community. Additionally, it supports the conclusions of many scholarly studies that have identified psychological abuse as normalised within the context of competitive/high-­performance sport (Brackenridge  & Fasting, 2005; Gervis  & Dunn, 2004; Kirby et al., 2000; Parent & Bannon, 2011; Stirling & Kerr, 2008a, 2009, 2012, 2014; Tomlinson & Yorganci, 1997). Coaches from the study discussed in this chapter identified a number of reasons verbal forms of psychological abuse have been and continue to be an issue within competitive women’s volleyball. Some of the reasons that coaches identified were indicative of the nature of competitive sport (i.e. the focus on results), the role of the coach (i.e. expectations of the coach by the athlete), cultural aspects of competitive sport (i.e. inadequate coach education), and coaching policy (i.e. not readily available). Given that little attention has been paid to verbal forms of psychological abuse in high-­ performance sport, this research sought to specifically ask the participant coaches for their views of psychological abuse with an emphasis on verbal behaviours. In response, the interviewed coaches acknowledged verbally psychologically abusive behaviours such as comments including jokes, insults, and verbal remarks that were directed at the athlete’s personality or appearance. 76

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The findings on verbal psychological abuse are in line with the results from Stirling and Kerr’s (2014) study on emotional abuse in sport, which categorised verbal behaviours as a distinct form of emotional abuse. As such, an important consideration for athlete welfare is to begin to raise awareness of verbal abuse as a form of psychological abuse that warrants attention and to educate coaches on what constitutes verbal psychological abuse and how to communicate effectively with athletes in a way that is not abusive. In addition to identifying what verbal psychological abuse involved, coaches also provided insight into their understandings of how yelling or verbal forms of abuse can become psychological abuse. According to participants, psychological abuse causes athletes mental and emotional turmoil, and it occurs when both comments and/or actions towards athletes cause feelings of emotional distress. In light of the lack of attention paid to psychological abuse in the policies and guidelines for women’s volleyball and the coach education sources coaches reviewed as part of their training, it is not surprising that coaches in this study found it difficult to define psychological abuse, even though they could readily come up with examples of it occurring. In particular, when discussing examples of psychological abuse, the coaches told stories of either athletes they worked with or their own athlete experiences, and they frequently connected these stories to the personal or subjective nature of psychological abuse. More specifically, they highlighted the importance of the athletes’ lived experience as a major aspect of experiencing psychological abuse. Based on the perspectives and examples provided by the participants, it is clear that coaches understand verbal behaviours as a form of psychological abuse while at the same time acknowledging that this kind of abuse is often subjective. In discussing solutions to the normalised occurrence of verbal psychological abuse in competitive/high-­ performance sport, the participants felt that improved coach education, alongside clear and concise sport policy, as well as repercussions for coaches who psychologically abuse their athletes, whether verbally or otherwise, were the best ways to address these forms of abuse. More pointedly, the participants felt their coach education was inadequate and all, except for one coach, were unaware of any policies that operated at the PSO level on psychological abuse. In addition, when coaches discussed implementing sanctions for psychologically abusive coaches, they made comments such as: I don’t think we’ve done a lot to kind of try and address it as a volleyball community. I think that’s something that would be good to see. If we just keep not doing anything, it doesn’t really get any better. This quote clearly demonstrates that in addition to improvements in coach education and policy and more repercussions for coaches, there is a need to address verbal psychological abuse including its verbal forms more broadly and in this volleyball community specifically. While the insights of the coaches are valuable, it is important to mention how education and policy, as products of a volleyball community that has done little to address athlete psychological abuse, may be insufficient means to address the issue of abuse in sport. This is especially the case given that high-­performance women’s volleyball in Canada is one example of a specific sporting community that is part of a larger competitive/high-­performance structure of sport that has currently accepted abuse as a part of the athlete experience.

Athlete welfare considerations Although this research was limited to the views of eight coaches5 from one specific competitive/ high-­performance sport community, the findings are nonetheless important and contribute to 77

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the current lack of literature that explores the views of coaches on psychological abusive coaching behaviours, and especially verbal forms of this, in competitive and high-­performance sport. Based on the responses from these coaches, there is a need for more effective coach education, policies on psychological abuse (which specifically include a definition of verbal psychological abuse), and the appropriate sanctioning of abusive coach behaviours (i.e. repercussions for abusive coaches). Although the coaches in this study were aware of sanctions, it was their perception that very few coaches were sanctioned for psychologically abusing athletes, largely because of the normalisation of verbally psychologically abusive coaching behaviours and the tight-­knit community of women’s volleyball within the province. As such, it is important for sporting communities to find ways to regularly evaluate their coach education materials by conducting research on coach experiences of coach education and, where necessary, using the data collected (for example, through observation, interviews, focus groups, and questionnaires) to improve and revise these. Additionally, it is important to have clear policies that are explicit and outline the procedures and resources in place for coaches and athletes alike who may be experiencing any form of abuse. Coaches and the organisations they are employed under need to take educating their coaches, athletes, and other key stakeholders (e.g. parents) on the existence of these policies seriously in order to limit challenges to accessibility and ensure that members of the community are aware that protective policies exist. Finally, in clarifying these policies, coaches in the study reported here also specified that it is important to both outline and follow through on the repercussions for coaches who are appropriately investigated and found to be abusing athletes. What and how these repercussions are structured will depend greatly on the sporting context. However, coaches in this study felt that facing disciplinary sanctions was a starting point for penalising abusive coach behaviour.

Notes 1 The coaches that were interviewed for this research were coaching at the 18U, university, and national sport levels. The Canadian Sport Policy (CSP) outlines competitive sport as being aligned with the Train to Train, Train to Compete, and Train to Win stages of athlete development and high-­performance sport. These stages of athlete development are borrowed directly from the long-­term athlete development (LTAD) model, created and written by the Canadian Sport for Life organisation, which categorises athletes at the Train to Train, Train to Compete, and Train to Win stages as being from high-­performance clubs, universities or colleges, and national or Canadian sport centres. Additionally, this study was specific to the sport of volleyball. As stated on Volleyball Canada’s website, athletes aged 18 years or older fit into the Learning to Compete, Training to Compete, Learning to Win, and Training to Win stages of the LTAD. Therefore, the coaches within this chapter are referred to as competitive/high-­performance coaches. 2 In 2017, Alpine Ski coach Bertrand Charest was sentenced to 12 years in prison for sexual offences against many minor athletes who were part of the Canadian Olympic Alpine Ski team. Additionally, Alpine Canada was sued by victims of Charest, based on allegations that Alpine Canada covered up the abuse suffered by athletes. The following link provides a detailed report on the allegations: www.cbc.ca/ sports/olympics/alpineskiing/sexual-­assault-­victims-­suing-­alpine-­canada-­1.4942675 3 Forty years ago, the Canadian Broadcasting Corporation started a series of investigative documentary programming called the Fifth Estate, with the intent to “bring in-­depth investigations that matter to Canadians” on a range of topics. In the 1993 broadcast titled ‘Crossing the Line’, the topic of conversation was sexual abuse in high-­performance Canadian sport. Specifically, in this programme, university female athletes from volleyball, swimming, and rowing who had been sexually abused by their male coaches were interviewed. This was one of the first publicly broadcast conversations concerning the well-­concealed reality of sexual abuse in high-­performance sport. Unfortunately, there is no online link to this video, but a hard copy does exist in the CBC archives. 4 A recent investigative report by the CBC documented how severe the under-­ reporting of sexual abuse in Canadian sport is. The statistics presented in this report demonstrate the number of 78

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sexual offences per sport and per province as well as the gendered nature of these sexual offences. The full story including the statistics mentioned here can be found at this link: www.cbc.ca/sports/ amateur-­sports-­coaches-­sexual-­offences-­minors-­1.5006609. 5 This chapter uses only data generated from semi-­structured interviews conducted as a part of a larger study undertaken for a Masters research project. Other forms of data were used in the initial study, namely auto-­ethnography and content analysis of coach policy documents. The complete study can be found at the following link: https://mspace.lib.umanitoba.ca/bitstream/handle/1993/30997/Final%20 Thesis%20Document%20%28Alix%20Krahn%207757385%29.pdf?sequence=1 6 Although the research from the study on which this chapter is based was on verbal and mental abuse, the author has employed the term ‘psychological abuse’ for the purposes of this book chapter. 7 Respect in Sport is a mandatory coach education module that all coaches must take in order to coach in the province where this research was conducted. This training promotes itself as equipping coaches with the knowledge they need to identify and deal with abuse, neglect, harassment, and bullying in sport. Completing the course requires viewing a short series of online videos, followed by a quiz at the end of each section. Given that this training is online only, there is no way to confirm whether coaches completed the training themselves. Several coaches in this study told stories about knowing coaches who had other people complete it for them. 8 The Making Ethical Decisions module is a mandatory coach evaluation that all coaches in Canada must complete. It is positioned by the CAC as a “cornerstone” of coach education, and it promises to leave coaches competent in handling ethical situations (CAC, 2019, para. 2). The CAC does not require all coaches to attend a MED workshop or even take the online tutorial; however, all coaches must take the online evaluation and achieve a passing grade of 75%. Only if a participant fails this evaluation must they then take the online tutorial or attend a workshop. If a coach decides to take the workshop prior to doing the evaluation, they are then afforded an unlimited number of opportunities to pass the online evaluation (Coaching Association of Canada, 2019, para. 7).

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7 Presenteeism in elite sport organisations A framework for understanding athletes’ decisions to practise sport despite health concerns Jochen Mayer, Felix Kühnle and Ansgar Thiel

Introduction In recent years, health research has been increasingly concerned with the phenomenon of attending work while ill. The discourse about “sickness presenteeism” (Aronsson, Gustafsson & Dallner, 2000, p.  502) focuses on situations in which employees maintain social functioning despite perceiving themselves to be sufficiently ill to have legitimately called in sick (Hansen & Andersen, 2008). Sickness presenteeism is considered a universal phenomenon that can be observed in a wide range of occupational settings (Kinman, 2019). In the sports context, keeping up social functioning despite having a health condition or feeling ill is a common social practice. However, practices referred to as ‘playing hurt’ (Roderick, Waddington & Parker, 2000), ‘playing through pain’, or ‘competing injured’ (e.g. Howe, 2001) have only recently been linked to general presenteeism discourses in the health sciences. In this regard, the decision to train and compete despite having a health problem can be defined and empirically analysed as a sport-­specific form of sickness presenteeism among athletes (Mayer & Thiel, 2018; Mayer et al., 2018). In general, analysing presenteeism is crucial because this practice might not only exacerbate existing medical conditions but also damage the quality of (working) life or reduce effectiveness and productivity (Kinman, 2019). In the sports context, training and competing hurt can also significantly impair an athlete’s welfare and cause a great deal of harm (Kerr & Stirling, 2017). Apart from potential short-­term effects related to exacerbating medical conditions, presenteeism can also be associated with a series of long-­term consequences, such as causing acute pain to become chronic, or causing irreversible physical damage, or recurring traumatic injuries (Mayer, 2010; Thiel, Mayer & Digel, 2010). Thus, ignoring health issues can negatively affect athletic performance and a successful sports career and even hinder the ability to pursue an active lifestyle after sport (Wiese-­Bjornstal, 2009). As child and adolescent athletes are confronted with numerous physical, mental, and social transformations that constitute a sensitive developmental stage (Pike & Scott, 2015; Thiel et al., 2011), they are deemed particularly vulnerable to harmful 81

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short-­and long-­term consequences of presenteeism. However, being “sick but yet at work” (Aronsson et al., 2000, p. 502) might also turn out to be personally beneficial for athletes under certain circumstances, as it shows commitment to the organisation and can result in praise and recognition from, for example, coaches, teammates, or the mass media. From this perspective, training and competing hurt could also be interpreted as an individual strategy that fosters good mental health and social well-­being. Against this background, the appropriate management of presenteeism in (adolescent) elite sports and beyond is a delicate balancing act. This makes it particularly important to systematically analyse the phenomenon to investigate the various psychosocial influences on decisions to compete hurt, to systematically observe the potential consequences, and to develop appropriate interventions to manage this issue. Yet a theoretical model addressing presenteeism-­related (and absenteeism-­related) decision-­making is still needed. For that reason, the aim of this chapter is to present a holistic decision-­based framework to better understand athlete presenteeism in elite sport organisations and its consequences.

Existing frameworks referring to presenteeism-­related decision-­making Presenteeism-­related decision-­making is indirectly addressed in models capturing the return-­ to-­sport-­process. In this regard, general or condition-­specific recommendations are published that are derived from medical practice or clinical studies or represent the expert consensus about how and when an injured athlete is approved to return to sport (i.e. Dijkstra, Pollock, Chakraverty & Ardern, 2017; Huang, Anissipour, McGee & Lemak, 2016; Shrier, 2015). A general orientation for return-­to-­play decisions, which are primarily constructed as clinicians’ decisions, is given by the model of “Strategic Assessment of Risk and Risk Tolerance (StARRT)” (Shrier, 2015). The key elements of this normative framework are the assessment of health risk (step 1), the assessment of activity risk (step 2), and the assessment of risk tolerance (step 3). In step 3, the so-­called ‘decision modifiers’ accentuate a necessity to include sports network-­related expectations in the return-­to-­play decision, such as seasonal phase, external pressures, or practices of masking the injury. Although the StARRT model comprehensively sums up available research and clinical expertise in order to provide guidance for appropriate decision-­making, it does not intend to capture the process of actual return-­to-­play decision-­making. Moreover, the model does not intend to explain why athletes play hurt and which consequences could be associated with this behaviour, as it is not conceptualised as a theoretical framework for analysing the psychosocial mechanisms affecting actual decision-­making within sports. However, the ‘dynamic model of presenteeism and absenteeism’ (Johns, 2010), which unites a variety of empirically identified predictors and health-­related consequences from general presenteeism discourse, can function as a starting point for a decision-­based theoretical framework. The basic assumption of this model is that the decision between presenteeism and absenteeism is the result of an interplay between the characteristics of the underlying health event, the work context, and personal factors. This broadly accepted model was adjusted to the elite sports workplace by Mayer and Thiel (2018) and specified in order to empirically analyse the athlete’s willingness to compete hurt (WCH) in a theory-­driven approach. Although this model integrates several sports context-­related factors and aspects of the individual athletes’ personal background, it does not explicitly address the decision-­making process. Considering findings from other work settings (see e.g. Kinman, 2019), we argue that presenteeism in sport (and beyond) is a highly complex phenomenon that can take on very different forms; is caused by multiple, interrelated factors; and is associated with observer-­dependent consequences (Mayer & Kühnle, 82

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2020). To capture these complexities, we further elaborated the ‘dynamic model of competing hurt’ (Mayer & Thiel, 2018), primarily based on systems theory considerations1 and empirical findings about injury-­related decision-­making (Mayer, 2010) and health management in German elite sport organisations (Thiel et al., 2010). These were combined with important findings from the sociology of sport discourse on pain and injury and relevant knowledge from general presenteeism research. Doing this, we distinguish between social and psychic systems and focus on the relevance of organisational structures to offer a holistic framework for understanding presenteeism and absenteeism-­related decision-­making and its consequences.

A decision-­based framework for presenteeism in athletes: A process–structure model of competing hurt decision-­making The starting point of the decision-­based framework for presenteeism in athletes (see Figure 7.1) is the ideal of the person’s unrestricted ability to perform in training and competition. This means that the current state of health matches the performance expectations and other demands of the relevant sports setting and allows regular attendance without the need to consciously Unrestricted Ability to perform in Sports

Elite sport system System logic oriented towards victory / defeat

Health event acute - chronic - episodic physical - mental - biopsychosocial

Athlete: Personal self-expectations - Athletic identity - Health & illness representations - Willingness to compete hurt

Elite sport organisation: Decision premises Decision-making scenario complexity of health event avoidability of absenteeism social embeddedness temporal necessities

- Decision programmes (i.e. return-to-play protocols) - Communication channels (i.e professional secrecy) - Personnel (i.e. coach, medical team) - Organisational culture (i.e. presence culture, locker room talk)

Decision-making process Other potentially relevant systems

prestructure vs. flexible individual vs. shared confidential vs. unconfidential

System logics related to Family, Education, Mass Media, Economy & Politics

Medical system & organisations System logic & decision premises oriented towards promoting / hindering health

Decision

Compete Hurt (Presenteeism)

Rest (Absenteeism)

Consequences pathogenetic - salutogenetic - welfare personal vs. social

Figure 7.1 A  decision-­based framework for presenteeism in athletes: The process–structure model of competing hurt decision-­making. 83

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decide whether to withdraw from sport. However, this idealistic state of athlete well-­being is permanently challenged by common illnesses, everyday health issues, and the additional threat of sports injures and other sport-­related illnesses. According to Luhmann (1983, p. 174), pain, in particular, immediately attracts the affected person’s attention. Due to its acute character, it thus synchronises the consciousness of the affected person with the present tense. Consequently, the need to make a decision arises as soon as the state of health is affected. As soon as a health event is detected, the initial decision-­making scenario is set up. This scenario is primarily shaped by the nature of the health event but also by its social embeddedness and temporal necessities. In the following, we will further elaborate on these factual, social, and temporal characteristics of the initial decision-­making scenario as they predefine the actual decision-­making process, which finally culminates in the decision to be made.

Health events as decision-­making triggers The nature of the health incident that interrupts an athlete’s unrestricted ability to perform is considered a major factor, as it affects the overall decision-­making process. Health events thus function as presenteeism and absenteeism decision-­making triggers. The range of possible health incidents leading to presenteeism in the sports context is obviously very broad (Mayer & Thiel, 2018). From a pathogenetic perspective, this includes acute, chronic, or recurring symptoms of any kind of illness or injury. The symptom complexes can be related to a primarily physical problem, to mental issues, or to multifaceted biopsychosocial health problems. Furthermore, it is likely that the medical complexity and severity attached to the underlying health event, as well as the associated uncertainty about its progress, also affect the following decision-­making procedure. From a salutogenetic or well-­being perspective, any kind of subjective complaint, feeling of ill-­health, or unwellness experienced can be the starting point of a decision-­making process. Nevertheless, all health incidents can be placed on a ‘continuum of avoidability’ (Nicholson, 1977), representing the interrelation of an individual’s state of health and its specific job demands (i.e. in this context, the sport’s discipline-­specific demands within the [elite] sports context). There are certain injuries or illnesses that simply do not allow an athlete to function sufficiently to practise sports (i.e. severe fractures). However, on the other end of the avoidability continuum, there are relatively minor health complaints that barely affect the ability to perform in training or competition, like, for example, a slight headache (Mayer & Thiel, 2018). In any case, this interrelation of an athlete’s health issue and a particular sport’s discipline-­specific demands highly affects if absenteeism is the choice at hand or if presenteeism can be considered a legitimate action (Mayer et al., 2018).

The social embeddedness of decision-­making Presenteesim decisions are not only a personal matter for athletes; they are pre-­structured by the social configuration of the specific decision-­making situation. In a way, health problems bring the social interdependence of action in sports to the fore. First of all, athletes act within the elite sports system’s logic, with its performance expectations oriented towards gaining victory and avoiding defeat. As members of sport organisations, athletes participate in competitions on an international and national level representing teams, national squads, or themselves. If a health event occurs within this “ ‘work context’ of elite sports” (Mayer & Thiel, 2018, p. 53), the presence and behaviour of significant others such as coaches, team members, or available medical staff have to be considered. In particular, if a health incident happens during training or competition, communication processes likely occur, and decision-­making becomes a public matter 84

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and a social procedure. Even if the initial health event is located in a private or leisure setting, stakeholders such as medical experts, team doctors, or coaches are available to be involved in the decision-­making process. However, to some extent, athletes have the opportunity to hide their health issues and keep the decision-­making process a private matter, for example, by not communicating any symptoms and/or by trying to act normally (Mayer, 2010).

Temporal necessities of decision-­making Another aspect that predefines the decision-­making process are the temporal necessities resulting from the health event’s particular time of occurrence. The perceived time frames for potential treatment, recovery, and return-­to-­sport scenarios likely affect which alternative initially emerges as the most promising. Another temporal characteristic affecting the overall decision-­ making process is the amount of time available to obtain relevant information, to build social consensus, and to make a final decision. Thus, perceived time pressure is likely to restrict the opportunity for comprehensively well-­informed and/or well-­discussed decisions. This is mostly the case if a health incident happens during a competition or right before an upcoming competition. In combination with difficult health issues, such as a suspected concussion, time pressure further enhances the overall complexity of the decision-­making scenario and the subsequent scenario-­dependent decision-­making process. Moreover, research shows that it makes a significant difference if a health event appears during the off-­season as compared to the main season or if an injury occurs prior to a career-­defining competition versus before a relatively unimportant seasonal phase with lowered expectations to compete at all (Roderick, 2006). Thus, the time of occurrence of the health event appears to be closely linked to the perceived sporting consequences related to the alternative of absenteeism. Reflecting the social embeddedness and temporal necessities of presenteeism-­related decision-­making, it becomes obvious that the social structures of the field not only predefine the initial scenario but also affect the overall decision-­ making process and its outcomes.

Scenario dependent decision-­making processes These outlined characteristics strongly suggest that different initial presenteeism scenarios exist that affect the subsequent decision-­making process. From a systems theory perspective, this process finds its end in the choice of one of the constructed action alternatives. According to Luhmann (2000), decisions are a specific form of observation that are basically characterised by alternativity. A decision itself is defined as the moment of selecting one alternative and as a “date-­bound event” that separates two distinct situations: One situation of choice under uncertainty and one situation in which the decision’s consequences have to be dealt with (Luhmann, 1984, p. 593). During the course of ‘uncertainty reduction’ through information processing, various expectations about the situation’s characteristics and its prospects are created. Such decision-­related expectations shape the construction of situation-­specific alternatives and influence judgement processes both before and after a decision is made (Luhmann, 1984, 1995). Persistent expectations reduce the complexity of a decision-­making situation through their general orientation function. Such complexity-­reducing expectations can be assigned to several system levels (Luhmann, 1995). The social structures on a societal and organisational level, such as contextual rationalities and decision premises, that constitute generalised behavioural expectations are highly relevant in health-­related decision-­making in elite sports. However, on an interactional level, further situation-­specific expectations about whether to compete hurt can 85

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also come into play (Mayer, 2010). Still, the individual structures of psychic systems in the form of self-­expectations, such as the willingness to compete hurt or other health and illness-­related representations, are likely to play a significant role within this process. In the following section, this orientation function of social and personal self-­expectations within the decision-­making process is further elaborated on.

The influence of generalised behavioural expectations at a societal level Reflecting the broader societal context of presenteeism in sports, it becomes obvious that different contextual rationalities have to be considered. These not only frame the initial decision-­ making scenario but also function as central judgement criteria within the decision-­making process. From a systems theory perspective, the decision-­making problem is located at the interface of at least two societal subsystems (Mayer, 2010). First, the decision is shaped by the elite sport system, with its binary code of victory/defeat and its central orientation on performance. Second, it is influenced by the medical system, with its binary code of promoting­/ hindering health and its basic orientation of healing patients (Cachay & Thiel, 2000). Theoretically, the logic of these two systems simultaneously applies and, in most injury-­related decision-­making situations, they are mutually exclusive (Mayer, 2010). This often leads to a “pragmatic paradox” (Watzlawick, Beavin & Jackson, 1969, p. 178) that can only be solved in the specific decision-­making situation. This means that in one case, the rationale of performing in competition has to be favoured over the rationale of healing (i.e. an athlete who is injured plays an important competition and risks further health damage), yet in another situation, the opposite rationale could also occur (i.e. an athlete who is injured takes a layoff despite a career-­relevant competition). Additionally, the (binary) logic of other functional systems in modern society can influence relevant behavioural expectations. Depending on an individual athlete’s peculiarities, the specific logic of the educational or mass media system, as well as expectations resulting from other social contexts, including family, friends, and personal networks, may affect an athlete’s decision. Both from an individual athlete’s and a professional sports team’s perspectives, there might also be the need to consider the logic of the economic system and financial consequences as well. Because of these multiple contextual rationalities, an overall rational decision in terms of what is ‘right’ or ‘wrong’ for an athlete becomes impossible; what might be the ‘right’ medical decision could be the ‘wrong’ decision in terms of sports success, mass media support, and short-­term financial gain. Thus, the different systems’ logic, with their own contextual rationalities, have to be contextually negotiated in an appropriate way. However, findings on injury-­ related decision-­making in elite handball and track and field reveal that the dominant contextual rationality for decision-­making is commonly the logic of the sports system (Mayer, 2010). In this regard, team doctors work at a crossroads and function as mediators between sports-­related performance expectations and the precautionary culture of the medical system (Safai, 2003). Although doctors are educated within and professionally bound to the medical system’s logic of promoting health, sport physicians are, as Malcolm (2006) points out, subject to the dominance of the sports system’s logic. This results in dynamics of de-­professionalisation and client dependence when they are acting within a sports performance–oriented setting. However, the striking dominance of the sports system’s logic and its associated sports ethic (Hughes & Coakley, 1991) can be diluted by sport organisations’ social structures. Moreover, in accordance with general presenteeism research, there are persistent expectations related to the given sports workplace that either promote or hinder presenteeism in any given case. 86

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The influence of generalised behavioural expectations on an organisational level The decision-­making scenario and processes around competing hurt are predefined by the structures of sport organisations. From a systems theory perspective, organisations operate on the basis of decision-­making and primarily orientate their structures towards the general system’s logic of one societal subsystem (Luhmann, 2000). This makes them recognisable as, for example, economic enterprise, medical clinic, court, sport federation, or, of course, elite sport club. So-­called ‘decision premises’ function as organisational structures (Luhmann, 2000). These are specific expectations about what kinds of decisions have to be made in certain situations, which positions or committees are responsible for these decisions, and in what way decision-­ making processes are expected to be performed. In detail, they include decision programmes, channels of communication, personnel decisions, and organisational culture (Luhmann, 2000, for a discussion of decision premises in sport organisations cf. Thiel & Mayer, 2009).

Decision programmes Regarding competing-­hurt decisions, sport organisations can set decision programmes, including official rules addressing the conditions under which an injured player is allowed to return to play. In some sport federations, concussion protocols, for example, are supposed to structure the return-­to-­play decision-­making process in order to make better-­informed decisions based on medical regulations. In elite sport teams, it is likely that decision programmes exist that define how and when a player has to call in sick, which affects the agency a player has in terms of dealing with an acute health problem. In addition, there might be team-­specific regulations about replacements, for example, that for every team position, there are players who can stand in for absent peers. However, replacement by other athletes/staff, which is considered a protective factor at reducing presenteeism in other work settings (Elstad  & Vabø, 2008), might have contrary effects in sports teams due to the constant struggle for squad selection and contract extensions. Furthermore, it is possible that decision programmes exist that regulate the rehabilitation process and the inclusion of additional medical experts. In this respect, the differentiation of positions for team doctors and team physiotherapists is an essential decision premise, as they are supposed to secure fast decisions about diagnoses and treatments. As follows, the people who fill these designated roles shape the decision-­making process based on their subjective construction of the situation and their individual decision-­making skills (Mayer, 2010).

Communication channels and personnel Sport organisations can also predefine the actual decision-­making process by formally and normatively regulating who should be making the decision (Shrier, Safai & Charland, 2014). Is shared decision-­making the norm? Is the athlete responsible for making an informed decision? Or do the team doctor or coach determine whether the affected athlete is considered fit for competition? In this regard, sport organisations can set the level of individual athlete responsibility via communication channels and predefine how multidisciplinary perspectives are systematically incorporated. It is also possible via communication channels to regulate the extent of expected confidentiality between the medical team, the athlete, and the coaching and management staff. However, medical confidentiality is commonly challenged in sport organisations, as medical information is expected to be shared and athletes’ health problems are expected to be communicated widely (Murphy & 87

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Waddington, 2007). This can potentially result in increased social pressure for an athlete to compete hurt. Another way to indirectly steer the decision-­making process towards presenteeism is by the appointment of particular medical staff who are known to be eager to return injured athletes to play, who strongly identify with the sports team, or who, as former athletes themselves, have bought into the sports system’s logic (Thiel et al., 2010). In addition to making decisions about who is authorised to make decisions, the way health issues are formally addressed within the organisation also needs to be considered. For example, the leadership style of a coach appears to significantly affect the willingness of an athlete to compete hurt in certain sport disciplines (Mayer et al., 2018). However, the role of leadership styles as this relates to an individual’s interpretation of the power attached to a position is not yet clear in the sports context and, according to Bokhari, Ahmad and Hyder (2017), is a controversially discussed issue in general presenteeism research as well.

Organisational culture and communication In research on general presenteeism, workplace cultures have a substantial influence on both promoting or hindering the presenteeism of organisational members (Dew, Keefe  & Small, 2005). According to Luhmann (2000), organisational cultures function as undecided decision premises, as they evolve around existing formal rules and regulations. Thus, organisational culture becomes even more relevant if decision-­making is ‘organised’ as a highly flexible endeavour. Cultures of sports-­related presenteeism can comprise shared values about acceptable reasons for cancelling competitions, informal knowledge about how to appropriately deal with pain, or unspoken expectations, such as giving everything for the team’s success (Mayer, 2010). In this regard, the sport discipline-­specific translation of the ‘culture of risk in sport’ (Nixon, 1992) appears to have an effect on presenteeism-­related decision-­making. Nevertheless, Schnell, Mayer, Diehl, Zipfel and Thiel (2014) also show that among German elite adolescent athletes, the acceptance of physical health risks depends on various individual (i.e. perfectionistic personality, athletic identity) and context-­specific factors (i.e. pressure from the social environment) that constitute different athlete groups. Referring to organisational cultures, the particular communication structures within organised interaction systems2 play a central role in the individual and collective construction of the decision-­making scenario and process. In health-­related social interaction within sport teams, the thematic content and personal relations appear to be crucial (Mayer, 2010). One typical interaction system is, for example, a locker-­room communication about the need to replace an athlete who is experiencing pain in the second half of a game. This communication might include the affected athlete, the coach, the team doctor, and the team physiotherapist. In such a situation, pain-­and injury-­related expectations are generated in different ways (Mayer, 2010). First, there might be persistent expectations in the form of decision programmes and communication channels as addressed previously, concerning, for example, to what extent the recommendation of medical staff is binding. Second, there are situation-­specific expectations, which result directly from the communication itself. This could be the collectively generated medical diagnosis, the perceived available options for treatment, or the assumptions made about layoff time needed. Additionally, there is the potential that athletes are either directly forced to or effectively prevented from playing hurt simply by addressing this issue in the particular situation. Such communicative actions can either enhance the effectiveness of or contradict existing decision-­making procedures and regulations. For example, as Malcolm (2009) notes, this is the case if newly implemented return-­to-­play protocols are collectively undermined by the athlete, the medical team, and the coaching staff. 88

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In conclusion, sport organisations have the power to structure the decision-­making process in both a presenteeism-­promoting or presenteeism-­hindering way. The particular design of the decision premises sets the individual athlete’s flexibility in deciding whether to rest or to play and regulates the degree of confidentiality within communication. By defining return-­to-­play procedures, clearly assigning the decision-­making authority, and providing the opportunity for shared decision-­making, it is possible to create a sensitive environment that might restrict the emergence of an unregulated presenteeism culture. Otherwise, unregulated presenteeism cultures, communication-­averse leadership styles, or individual performance expectations of stakeholders can further enhance the latent pressure to play despite having a health problem.

The influence of affected athletes’ personal expectations Obviously from the beginning of the decision-­making process, the affected athlete, with his or her unique biographical background and personal identity, also plays a central role in whether to train/compete while sick or injured. Findings in health sciences show that presenteeism not only reflects the social pressures and constraints of work environments, cultures of presenteeism, and communicated expectations but also that individual career dynamics and subjective meanings of working despite illness play a role (e.g. Giæver, Lohmann-­Lafrenz & Løvseth, 2016). Thus, even though the world is a different place for each psychic system due to its individuality (Luhmann, 2008, p. 77ff), sporting success and other sport-­specific expectations are an elementary part of the self-­expectations that characterise the ‘athletic identity’ (Brewer, van Raalte & Linder, 1993). It is believed that athletes’ representations of health, illness, and injury are also shaped by and adjusted to this athletic identity (Thiel et al., 2010). In this regard, an individual athlete’s willingness to compete hurt is considered a major personal factor in decision-­making (Mayer et al., 2018; Mayer & Thiel, 2018). Based on the concept of absence/presence legitimacy (Harvey & Nicholson, 1999), an athlete’s willingness to compete hurt is conceptualised as an effect of socialisation into the elite sports context and represents this particular perception of absenteeism and presenteeism as legitimate behaviour in the given sports context (Mayer & Thiel, 2018). Findings from a survey study of 723 male and female German elite athletes in handball and track and field reveal that athletes make subtle distinctions between different kinds of health issues. Athletes were differentiated into two groups: Those who were “conditionally willing to rest” and those who were “rest-­averse and pain-­trivialising” (Mayer & Thiel, 2018, p. 49). In another survey of 1,138 German elite adolescent (14–18 years) athletes from a range of Olympic sports, Mayer et al. (2018) identified several groups with varying levels of WCH. The group with the highest WCH were athletes from technical sports who had a coach with an autocratic leadership style. The group of endurance and power sport athletes who experienced no direct social pressure showed the lowest levels of WCH by far. These findings illustrate how the sociocultural context of different elite sports affect the decision-­making process via the development of a sports discipline–specific WCH. In this respect, organisational structures can function as catalysts for presenteeism, particularly if a high WCH is culturally expected and the final decision-­ making authority is the sole responsibility of the athlete.

The consequences of presenteeism decisions on health and athlete welfare Given that all decisions are social attributions (Luhmann, 2000), every decision can be ascribed solely to either the athlete, the coach, or the team doctor, or it can be assigned as shared, with 89

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all these actors contributing simultaneously (Mayer, 2010). Considered from this perspective, it becomes obvious that presenteeism has several functions and that its observed consequences are relational. In general, personal and social consequences can be distinguished with regard to sporting, medical, financial, or reputational outcomes. Usually, presenteeism is regarded as a risky behaviour that is associated with negative health outcomes for the individual and with negative performance outcomes for the organisation (Skagen  & Collins, 2016). Within the sports context, similar consequences can be assumed. On an individual level, we consider it relevant to distinguish between a pathogenetic perspective, a salutogenetic perspective, and a biographical perspective. From a pathogenetic point of view, consequences of presenteeism relate to exacerbation of existing illnesses, injuries, or other medical conditions, such as mental illness or athlete burnout. However, qualitative studies in presenteeism point to the fact that the actors are often well aware of the risks and possible ill-­ health consequences. Still, they weigh up the advantages and disadvantages of presenteeism and absenteeism in a scenario-­dependent, context-­sensitive manner (Giæver et al., 2016). It is only recently that presenteeism has been discussed not only from a pathogenetic perspective but also from a salutogenetic point of view (Kinman, 2019). From this perspective, presenteeism functions as a resource that provides meaning in a difficult life phase or gives the feeling of continuing to be a capable person. Depending on the actual life situation, presenteeism might also have career-­defining implications and could lead to enhanced health resources, such as an increase in financial or social capital. Even if there are certain risks involved in the decision to play hurt, it might enable the person affected to master a biographical crossroads and to have more leeway in future decisions related to similar problems. In sum, if a distinction is made between biomedical and psychosocial consequences and if the complex biographical and athlete welfare effects of presenteeism behaviour are investigated, the overall picture becomes more ambiguous and is highly observer dependent.

Conclusion Based on the conceptualisation of competing hurt as sport-­specific form of sickness presenteeism, we developed a comprehensive decision-­based framework addressing presenteeism in athletes. This process–structure model is particularly suited to guiding further research on the topic, as well as to developing appropriate ways for holistic presenteeism management in elite sport organisations. In future research, further efforts are necessary to analyse the forms, functions, and consequences of presenteeism in athletes. In particular, it is important to identify the main factors in specific scenarios and the ensuing generative mechanisms that lead athletes to play hurt. To shed light on the complex interplay of these factors, sport discipline-­specific mechanisms that systematically push and pull athletes to presenteeism have to be identified. This is why theory-­ driven, qualitative case studies and quantitative cross-­sectional surveys are especially needed. Also of great relevance is the development of appropriate methods of data collection that enable researchers to analyse the phenomenon in its multidimensionality. The conceptualisation of ‘biographical presenteeism mapping’ (Mayer & Kühnle, 2020) is an important step in this direction. Moreover, longitudinal study designs need to be devised to explain the various effects of presenteeism on athlete health and well-­being, as well as on athlete welfare in general. In this context, it is particularly important to find out more about athletes’ retrospective evaluations of the decision-­making process. To date, little is known about the social mechanisms that guide retrospective evaluations of the decision-­making process and the positive and negative outcomes. It is presumed, however, that hierarchies in sport organisations not only influence the 90

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decision-­making process itself but also its evaluation in light of the eventual consequences. Even more importantly, a further challenge is to appropriately balance the potential health risks associated with presenteeism and the potential positive outcomes in terms of resources to strengthen resistance to it as well as to the individual biographical risks and rewards linked to this behaviour. As organisational decision premises – either providing or lacking regulations relating to the problem – have a competing hurt-­promoting and/or hindering effect, adequate management of return-­to-­play policies and regulations is crucial. According to Kinman (2019), multilevel approaches are required that include both systemic and individual-­level interventions. In a new study funded by the German Federal Institute of Sport Science, we conceptualise this idea to pursue the goal of individualised athlete development. The PRIO study3 is concerned with the implementation, evaluation, and optimisation of a complex intervention programme for participatory organisational development at Olympic training centres in Germany. It was developed with project partners from elite sport and aims to holistically promote performance and health in young athletes. The intervention is designed to optimise communication between athletes, their coaches, the medical team, and the extended sporting environment, as well as to develop targeted strategies based on participatory approaches. A  central goal is to improve decision-­ making processes based on the premise that athletes’ rights and welfare should be given priority.

Notes 1 In general, social systems theory is based on constructivism, communication theory, and the concept of autopoietic, self-­organising systems (see Luhmann, 1995). This approach is characterised by various interconnected theoretical concepts that allow the analysis of aspects of modern society on different social system levels (interaction, organisation, and society) as well as on a psychic systems level. Within the sociology of sport, this theoretical approach is already used to explain several phenomena; however, its full potential has not yet been capitalised on (Thiel & Tangen, 2015). 2 In systems theory, communication is understood as a three-­part selection process composed of information, utterance, and understanding (Luhmann, 1995). Within organised interaction systems, topics of communication are provided by the organisation, and the attendees perceive themselves in their role as members of the organisation (Kieserling, 1999). 3 For further information about the PRIO study, see: www.bisp-­surf.de/Record/PR020191200111

References Aronsson, G., Gustafsson, K. & Dallner, M. (2000). Sick but yet at work. An empirical study of sickness presenteeism. Journal of Epidemiology and Community Health, 54(7), 502–509. Bokhari, S. N., Ahmad, N. & Hyder, S. I. (2017). Presenteeism: A reflection of leadership styles among healthcare professionals in Karachi. Journal of Southeast Asian Research. doi:10.5171/2017.25507 Brewer, B. W., van Raalte, J. L. & Linder, D. E. (1993). Athletic identity: Hercules’ muscles or Achilles heels? International Journal of Sport Psychology, 24(2), 237–254. Cachay, K.  & Thiel, A. (2000). Soziologie des Sports. Zur Ausdifferenzierung und Entwicklungsdynamik des Sports der modernen Gesellschaft [Sociology of sports. On the differentiation and developmental dynamics of sports in modern society]. Weinheim and München: Juventa. Dew, K., Keefe, V. & Small, K. (2005). “Choosing” to work when sick: Workplace presenteeism. Social Science and Medicine, 60(10), 2273–2282. Dijkstra, H. P., Pollock, N., Chakraverty, R.  & Ardern, C. L. (2017). Return to play in elite sport: A shared decision-­making process. British Journal of Sports Medicine, 51(5), 419–420. Elstad, J. I. & Vabø, M. (2008). Job stress, sickness absence and sickness presenteeism in Nordic elderly care. Scandinavian Journal of Public Health, 36(5), 467–474. Giæver, F., Lohmann-­Lafrenz, S. & Løvseth, L. T. (2016). Why hospital physicians attend work while ill? The spiralling effect of positive and negative factors. BMC Health Services Research, 16(1), 548. 91

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Hansen, C. D. & Andersen, J. H. (2008). Going ill to work: What personal circumstances, attitudes and work-­related factors are associated with sickness presenteeism? Social Science and Medicine, 67(6), 956–964. Harvey, J. & Nicholson, N. (1999). Minor illness as a legitimate reason for absence. Journal of Organisational Behaviour, 20(6), 979–993. Howe, P. D. (2001). An ethnography of pain and injury in professional rugby union: The case of Pontypridd RFC. International Review for the Sociology of Sport, 36(3), 289–303. Huang, P., Anissipour, A., McGee, W. & Lemak, L. (2016). Return-­to-­play recommendations after cervical, thoracic and lumbar spine injuries: A comprehensive review. Sports Health, 8(1), 19–25. Hughes, R. & Coakley, J. (1991). Positive deviance among athletes: The implications of overconformity to the sport ethic. Sociology of Sport Journal, 8(4), 307–325. Johns, G. (2010). Presenteeism in the workplace: A review and research agenda. Journal of Organisational Behaviour, 31(4), 519–542. Kerr, G. & Stirling, A. (2017). Issues of maltreatment in high performance athlete development: Mental toughness as a threat to athlete welfare. In Baker, J., Cobley, S., Schorer, J. & Nattie, N. (Eds.), Routledge handbook of talent identification and development in sport (pp. 409–420). London: Routledge. Kieserling, A. (1999). Kommunikation unter Anwesenden. Studien über Interaktionssysteme [Communication among people who are present. Studies on interactional systems]. Frankfurt and Main: Suhrkamp. Kinman, G. (2019). Sickness presenteeism at work: Prevalence, costs and management. British Medical Bulletin, 129(1), 69–78. Luhmann, N. (1983). Medizin und Gesellschaftstheorie [Medicine and theory of society]. Medizin, Mensch, Gesellschaft, 8, 168–175. Luhmann, N. (1984). Soziologische Aspekte des Entscheidungsverhaltens [Sociological aspects of decision-­ making]. Die Betriebswirtschaft, 44(4), 591–603. Luhmann, N. (1995). Social systems. Stanford: Standford University Press. Luhmann, N. (2000). Organisation und Entscheidung [Organisation and decision]. Wiesbaden: VS Verlag. Luhmann, N. (Ed.). (2008). Soziologische Aufklärung. Bd. 6: Die Soziologie und der Mensch (3 Aufl.) [Sociological enlightenment. Vol. 6: Sociology and the human being (3rd ed.)]. Wiesbaden: Verlag für Sozialwissenschaften. Malcolm, D. (2006). Unprofessional practice? The status and power of sport physicians. Sociology of Sport Journal, 23(4), 376–385. Malcolm, D. (2009). Medical uncertainty and clinician-­athlete relations: The management of concussion injuries in rugby union. Sociology of Sport Journal, 26(2), 191–210. Mayer, J. (2010). Verletzungsmanagement im Spitzensport. Eine systemtheoretisch-­konstruktivistische Analyse mit Fallstudien aus den Sportarten Leichtathletik und Handball [Pain and injury management in elite sports. A systems-­theoretical and constructivist analysis with case studies in professional athletics and handball]. Hamburg: Feldhaus. Mayer, J., Giel, K. E., Malcolm, D., Schneider, S., Diehl, K., Zipfel, S. & Thiel, A. (2018). Compete or rest? Willingness to compete hurt among adolescent elite athletes. Psychology of Sport and Exercise, 35, 143–150. Mayer, J.  & Kühnle, F. (2020). Biografisches Präsentismus-­ Mapping. Mehrdimensionale Analyse des Präsentismusverhaltens auf Basis einer Visualisierungsmethode aus der Leistungssportforschung [Biographical presenteeism mapping. Multi-­dimensional analysis of presenteeism behavior based on a visualisation method developed in elite sports research]. Praxis Klinische Verhaltensmedizin und Rehabilitation, 109, 42–59. Mayer, J. & Thiel, A. (2018). Presenteeism in the elite sports workplace: The willingness to compete hurt among German elite handball and track and field athletes. International Review for the Sociology of Sport, 53(1), 49–68. Murphy, P. & Waddington, I. (2007). Are elite athletes exploited? Sport in Society, 10(2), 239–255. Nicholson, N. (1977). Absence behaviour and attendance motivation: A conceptual synthesis. The Journal of Management Studies, 14(3), 231–252. Nixon, H. L. (1992). A social network analysis of influences on athletes to play with pain and injuries. Journal of Sport and Social Issues, 16(2), 127–135. 92

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Pike, E. J.  & Scott, A. (2015). Safeguarding, injuries and athlete choice. In Lang, M.  & Hartill, M. (Eds.), Safeguarding, child protection and abuse in sport: International perspectives in research, policy and practice (pp. 172–180). London: Routledge. Roderick, M. (2006). The sociology of pain and injury in sport: Main perspectives and problems. In Loland, S., Skirstad, B.  & Waddington, I. (Eds.), Pain and injury in sport: Social and ethical analysis (pp. 17–33). London: Routledge. Roderick, M., Waddington, I. & Parker, G. (2000). Playing hurt: Managing injuries in English professional football. International Review for the Sociology of Sport, 35(2), 165–180. Safai, P. (2003). Healing the body in the “culture of risk”: Examining the negotiation of treatment between sport medicine clinicians and injured athletes in Canadian intercollegiate sport. Sociology of Sport Journal, 20(2), 127–146. Schnell, A., Mayer, J., Diehl, K., Zipfel, S. & Thiel, A. (2014). Giving everything for athletic success! Sports-­specific risk acceptance of elite adolescent athletes. Psychology of Sport and Exercise, 15(2), 165–172. Shrier, I. (2015). Strategic assessment of Risk and Risk Tolerance (StARRT) framework for return-­to-­play decision-­making. British Journal of Sports Medicine, 49(20), 1311–1315. Shrier, I., Safai, P. & Charland, L. (2014). Return to play following injury: Whose decision should it be? British Journal of Sports Medicine, 48(5), 1–8. Skagen, K. & Collins, A. M. (2016). The consequences of sickness presenteeism on health and well-­being over time: A systematic review. Social Science and Medicine, 161, 169–177. Thiel, A., Diehl, K., Giel, K. E., Schnell, A., Schubring, A. M., Mayer, J. et al. (2011). The German Young Olympic Athletes’ Lifestyle and Health Management Study (GOAL Study): Design of a mixed-­ method study. BMC Public Health, 11, 410. Thiel, A. & Mayer, J. (2009). Characteristics of voluntary sports club management: A sociological perspective. European Journal of Sports Management, 9(1), 81–98. Thiel, A., Mayer, J.  & Digel, H. (2010). Gesundheit im Spitzensport. Eine sozialwissenschaftliche Analyse. [Health in elite sports. An analysis from a social sciences perspective]. Schorndorf: Hofmann. Thiel, A. & Tangen, J. O. (2015). Niklas Luhmann, system theory and sport. In Giulianotti, R. (Ed.), Routledge handbook of the sociology of sport (pp. 72–82). London: Routledge. Watzlawick, P., Beavin, J. H.  & Jackson, D. D. (1969). Menschliche Kommunikation  – Formen, Störungen, Paradoxien [Pragmatics of human communication – A study on interactional patterns, pathologies, and paradoxes]. Bern: Huber. Wiese-­Bjornstal, D. M. (2009). Sport injury and college athlete health across the lifespan. Journal of Intercollegiate Sports, 2(1), 64–80.

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8 The issue of athlete welfare and why tackling should be removed from physical education and school sport #BanTackling Adam J. White

The campaign to ban tackling In March 2016, the Sport Collision Injury Collective (SCIC),1 with the backing of other academics, medical practitioners and educationalists, called upon the UK government to remove tackling from schools’ physical education (PE) classes. In their open letter, the SCIC highlighted that rugby has a high and serious risk of injury (Freitag, Kirkwood, Scharer, Ofori-­Asenso & Pollock, 2015; Kirkwood, Parekh, Ofori-­asenso & Pollock, 2015), that rugby injuries are not systematically recorded and analysed (Pollock, 2014), that most often contact rugby is a compulsory activity in school for boys (Nyiri, 2015; White, 2018), and that children’s rights are thus not being respected and their voices not being sought or heard by the rugby authorities (White et al., 2019). The debate on whether rugby tackling should be removed from the school context has been ongoing, with various organisations positioned on either side of this important issue (Pollock, White & Kirkwood, 2017; Tucker, Raftery & Verhagen, 2016). Rather than questioning the levels of harm associated with injuries in rugby, this discussion is split around the issues of informed consent and acceptable levels of risk, firmly positioning this as a sociopolitical issue (Quarrie, Brooks, Burger, Hume & Jackson, 2017; White et al., 2018b). While this debate continues, young people are continuing to engage in contact codes of rugby – often without them (or their parents) being required to give their informed consent – putting their physical welfare at risk. It is this social concern that I will attend to in this chapter, concluding that the removal of contact from rugby in physical education and school sport is both the only logical and viable solution available at this time (White, 2018).

Understanding injury in rugby The first element to any public health debate, including that in sport, is to understand the magnitude of the problem; in this instance, injury (Pollock, 2014). The process for monitoring and 94

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recording injuries is often different across different sports, meaning “direct comparison of injury risk between sports remains difficult because of varying definitions of injury and heterogeneity in study methods” (Spinks & McClure, 2007, p. 556). Indeed, even injury monitoring within the same sport over time can be inconsistent, with a variety of injury definitions, categorisations, and methodologies to collect data being deployed (Freitag et al., 2015). To address this, World Rugby defined a time-­loss injury as “an injury that results in a player being unable to take a full part in future rugby training or match play” (Fuller et al., 2007, p. 329). This means an analysis of the number of injuries (incidence) and the seriousness of the injury (severity) needs to be calculated (Van Mechelen, Hlobil & Kemper, 1992). Given that rugby is a contact sport, it is not surprising that it has a high risk of injury. The Community Rugby Injury Surveillance Project (CRISP), funded by the Rugby Football Union (RFU),2 commented that adult “rugby union has a relatively high risk of injury compared with other team sports” (Roberts, Trewartha, England, Shaddick & Stokes, 2013, p. 1). In the adult community game, findings from the first three seasons of the CRISP project established an injury incidence rate of 16.9 injuries per 1,000 hours of match exposure, with a mean time-­loss of 7.6 weeks away from play (Roberts et al., 2013). While there is no similar comprehensive approach to collecting epidemiological data in the youth or school game, there are a number of studies that explore the injury risk in these contexts. In a systematic review of 35 studies, Freitag and colleagues (2015) found a rate of 10.3 time-­loss injuries per 1,000 hours of match-­play for those under 21 years of age in rugby. In another systematic review of rugby injuries for those between 12 and 18  years, the incidence of time-­loss injuries (more than seven days away from rugby) ranged between 1.6 to 2.5 injuries per 1,000 playing hours and from 7 to 8.4 injuries per 1,000 playing hours (Bleakley, Tully & O’Connor, 2011). Most recently, and germane to the school context, Archbold and colleagues (2017) conducted a prospective epidemiological study in Northern Ireland. Consisting of 28 schools or 825 players, Archbold and colleagues (2017) found 426 injuries across a season, impacting 38% of the study’s participants. This equated to 29 injuries per 1,000 playing hours, with 49% of injuries (208 of 426) being so severe they resulted in 28 or more days away from play (Archbold et al., 2017). One of the study authors commented, “The lighter players were less likely to sustain injuries. Larger players are used more during games . . . with their higher injury risk correlating to a higher volume of collisions” (Bleakley, 2016). Similar studies in the school context have found comparable findings. For instance, Palmer-­Green and colleagues found an injury incidence of 47 and 35 injuries per 1,000 playing hours for academies3 and schools, respectively (Palmer-­Green et  al., 2013). Furthermore, Abernethy and MacAuley (2003) established that rugby accounted for 44.6% of Accident and Emergency school sport hospital admissions at one UK hospital, significantly higher than any other sport. While there is some epidemiological data available from the school environment, as presented previously, there is not sufficient data available for the physical education and school sport context (Pollock, 2014). The Health and Safety Executive (HSE)4 does not require schools to report if “an injury arises because of the normal rough and tumble of a game” (HSE, 2013, p. 3), meaning there is limited understanding of the level of risk in this environment. Despite this, in their review of rugby union injury studies over the last decade, Viviers and colleagues (2018) found that injury trends remain consistent throughout all levels of play. The tackle is the most common phase of play where injuries occur (Archbold et al., 2017; Haseler, Carmont & England, 2010). Freitag and colleagues (2015) found the percentage of injuries attributable to the tackle ranged from 39.6% to 64.0% across 11 original studies, and the recent Archbold and colleagues (2017) study found the tackle and other collision situations 95

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contributed 63.4% of injuries. Studies consistently and repeatedly show the tackle to be the most injurious phase of play across all age grades of youth playing full-­contact rugby (McIntosh, Savage, McCrory, Fréchède & Wolfe, 2010; Palmer-­Green et al., 2013).

Traumatic brain injuries and long-­term neurodegeneration Concussion, often termed a mild traumatic brain injury, is particularly concerning within rugby, including youth rugby (Kirkwood et al., 2015). For instance, in Archbold and colleagues’ (2017) study of school rugby, they found 81 of the 426 injuries were diagnosed concussions. Likewise, Kirkwood and colleagues (2015) found up to 6.9 concussions per 1,000 player-­hours for rugby union and up to 14.7 concussions per 1,000 player-­hours for rugby league. It is no surprise that they suggest that concussion in rugby is a serious issue. A concussion is a mild form of brain trauma (McCrory et al., 2017). The definition of a concussion is a somewhat dynamic concept in both sports medicine and general medicine, with different organisations continually (re)defining the condition (Meehan, 2017). This makes comparative research, particularly over time, problematic and unreliable. To address this, a number of sporting bodies developed the Consensus Statement on Concussion in Sport, which defines a concussion as “a traumatic brain injury induced by biomechanical forces” (McCrory et al., 2017, p. 839). While traditionally a concussion was diagnosed by a loss of consciousness (Malcolm, 2017; McCrory et al., 2017; Meehan, 2017), today there are six recognised domains within concussion diagnosis: 1) somatic signs, 2) cognitive/emotional symptoms, 3) balance impairment, 4) behavioural changes, 5) cognitive impairment, and 6) sleep/wake disturbance (McCrory et al., 2017). The symptoms of concussion are “vague and heterogeneous” (McNamee, Partridge  & Anderson, 2015, p. 193), with technology currently not sensitive enough to recognise the micro-­injuries that characterise mild traumatic brain injuries (Cantu & Hyman, 2012; Malcolm, 2017). Therefore, concussion “diagnosis and prognosis [is often] complicated and contested” (Malcolm, 2017), particularly as the injury is invisible. Many of the symptoms of a concussion could easily be mistaken for a variety of other medical impairments, for example, veisalgia (a hangover), which can be problematic in sports with associated drinking and social activities (Anderson, McCormack  & Lee, 2012). As such, many athletes, parents, coaches, officials, and volunteers in sport may find it difficult to differentiate a concussive injury (Meehan, 2011). It is not only the difficulty in recognising and diagnosing a concussion that is an athlete welfare concern; the neurological outcomes, both short-­and long-­term, are alarming, too (Pollock, White & Kirkwood, 2017). Post-­concussion syndrome, which affects between 38% and 80% of those who suffer mild head trauma, means they will be symptomatic for extended periods of time (Hall, Hall & Chapman, 2005). The debilitating impacts of this upon physical activity, sport participation, and everyday life can be significant. In addition to post-­concussion syndrome, concussion has been linked to other significant neurological and neurodegenerative conditions. For instance, Sariaslan and colleagues (2016), using a birth cohort of over one million individuals under the age of 26 in Sweden, found a significant relationship between concussion and receipt of disability pension, psychiatric inpatient admissions or outpatient visits, premature mortality, low educational achievement, and receipt of state welfare payments. Similarly, concussion has been associated with increased risk of all forms of dementia and Alzheimer’s disease (Li et al., 2017). Others have established that those who have suffered a concussion have a two-­fold risk of suicide comparative to the general population (Fralick et al., 2018). Taylor and colleagues (2018) found that concussion negatively 96

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impacted cognitive functioning (based upon global cognition, verbal memory, visual memory, visual motor, reaction time, and impulse control) and that the effects were detectable over one year after the concussion. Furthermore, concussion is also linked with increased suicide attempts and suicidal ideation (Fralick et al., 2018). Most notably, following widespread media attention and the release of Sony Pictures’ film Concussion (White & Franks, 2019), chronic traumatic encephalopathy (CTE) has been associated with concussive and subconcussive traumatic impacts within contact sport (Omalu et al., 2005, 2006), including rugby union (Stewart, McNamara, Lawlor, Hutchinson  & Farrell, 2015). This neurodegenerative disease pathology “is associated with gradual onset of neuropsychological, psychiatric and behavioural disturbance followed by progressive cognitive decline” (Stewart et al., 2015, p. 11). Thus far, American football is the only sport that has undertaken a substantial exploration into the brains of deceased athletes, finding that 110 of 111 brains tested could posthumously be diagnosed with CTE (Mez et al., 2017). In summary, the long-­term outcomes of concussion are significant and alarming. Kirkwood and colleagues (2015, p. 506) comment that there is “a significant risk of concussion in children and adolescents playing rugby union and rugby league evident from the studies included in this systematic review”. In a systematic review of children’s concussive injuries across sports in the United States, Pfister and colleagues (2016) found that rugby had the highest incidence rate of concussion, at 4.18 concussions per 1,000 athlete exposures. Ice hockey was second, with 1.20 concussions per 1,000 athlete exposures, followed by American football, with 0.53 concussions per 1,000 athlete exposures. The average was 0.23 concussions per 1,000 athlete exposures across all sports (Pfister, Pfister, Hagel, Ghali & Ronksley, 2016). Therefore, rugby has an 18-­fold increased risk of concussion injury in comparison to sport generally and an 8-­fold higher risk of concussion than American football. Given the high incidence of concussion in rugby, each of these neurological outcomes is a concern for an athlete’s welfare.

The structure and provision of school physical education and school sport The role of rugby union in the physical education and school sport curriculum is not clear. In the United Kingdom, physical education and school sport are a compulsory part of the National Curriculum in England and aim to ensure that all pupils “engage in competitive sports and activities” (Department for Education, 2013). While no sport is mandated via the National Curriculum, contact rugby union is a suggested sport for meeting the aims of the National Curriculum for physical education and school sport at Key Stage 3 and Key Stage 4. Smith and colleagues (2007), using a sample of seven schools, found 18.1% of male pupils participated in rugby union, with no data being offered for girls. For boys, rugby union was the sixth most popular activity, behind soccer (72%), badminton (40%), basketball (33%), athletics (26%), and tennis (21%). Data from 288 secondary schools in England, representing 8.43% of the number of secondary schools in the country and based on pupil numbers (293,414) is 9.1% of the national population, show that rugby union is the 10th most popular sport delivered as part of the PE curriculum (n = 234/288, 81.25%). When split by gender, rugby union is the 8th most delivered activity for boys (n = 229/275, 83.3%) and the 18th most delivered for girls (n = 151, 53.55%) (White, 2018). Given that there is limited epidemiological data within the physical education and school sport terrain, the best indicator currently available is the perception of risk from those in the 97

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context. Data from 233 subject leaders for physical education and school sport in England rated rugby union the highest-­r isk activity that they deliver, with 57% of schools that deliver rugby union rating it the highest risk. Second to this was trampolining, which 32% rated as the highest-­r isk activity delivered (White, 2018). Of course, trampolining does have ongoing training requirements for school teachers, unlike rugby. At present, there are no requirements for teachers (or coaches) to have any formal training in order to deliver contact rugby. The Association for Physical Education (AfPE), as the professional body for physical educators in England, offers expert guidance on the provisions that should be implemented to deliver an activity safely (AfPE, 2016). For rugby union, there is no recommendation on the levels of training expected or necessary to deliver contact rugby union or league. In contrast, the AfPE suggests: Staff teaching trampolining are strongly advised to show up-­to-­date and appropriate qualifications and expertise that demonstrate knowledge of the basic skills, techniques, and mechanics of the moves they are helping students to learn. (AfPE, 2016, p. 416) Likewise, for swimming, there is a requirement for those responsible for water safety to hold a current qualification or to have a lifeguard present (AfPE, 2016). The Rugby Football Union’s own Code of Practice5 also shows no training requirements to deliver contact rugby. A training audit conducted in October  2015 in 24 Oxfordshire Rugby Football Schools Union–affiliated schools found that only 39% of current PE teachers had any rugby coaching qualifications, and only 32% had completed a concussion education module; for state schools, this was 14%, with nine state schools having no teacher with concussion training. Similarly, even in targeted schools for the RFU as part of the All Schools initiative, 31% of schools had received no coaching development training (Pollock, White & Kirkwood, 2017). To this end, rugby union is currently commonly delivered in schools for boys, but teachers are often lacking in and not required to have formal education in its delivery.

Reducing risk Rugby union is a high-­r isk activity (Roberts et al., 2013; White, 2018), and there are a number of strategies that have been tested to attempt to reduce the risk of injury and concussion in the sport. For instance, protective equipment in the form of scrum caps has been tested and shown to have no effect on reducing concussion (Benson, Hamilton, Meeuwisse, McCrory & Dvorak, 2009). Similarly, education programmes have been introduced; for instance, the Rugby Football Union’s ‘Headcase’ programme. Yet these initiatives are often tertiary-­care focused and lack rigorous evaluation (Batten, White, Anderson & Bullingham, 2016). Most recently, attention has been focused upon the tackle technique (Tucker et al., 2017), which is yet to garner any positive protective effect (Pollock, White  & Kirkwood, 2017). Additionally, while Hislop and colleagues (2017) have suggested a pre-­activity movement control programme6 is beneficial for the reduction of injury and concussion, this has been critiqued for being statistically non-­significant and lacking feasibility in the PE context, and there may have been other variables that could explain the reduction in concussions beyond this initiative (White et al., 2018a). The options now available for reducing the risk of concussions are limited. At present, the only successful strategy for the reduction of concussion in sport has been observed in ice hockey with the removal of the body check (Black et al., 2016). It is, therefore, logical that 98

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the substitution of the tackle with a touch/tag should be the next viable step in the attempt to improve athlete welfare in rugby.

Informed consent A central cornerstone of the Sport Collision Injury Collective’s campaign to remove tackling from school physical education and school sport was the premise that contact rugby was most often compulsory. In a study of independent schools, Nyiri (2015) found that 77% of these schools made contact rugby a compulsory element of the curriculum. In state schools, 91% (n = 208/229) of schools that deliver boys rugby make the activity compulsory within the PE curriculum (White, 2018). Of course, there are not just structural forces at play; indeed, there is also the cultural pressure to participate in contact codes of rugby, too. Pringle and Markula (2005, p. 480), in their study of school rugby players, found that “rugby was a compulsory aspect of their youthful education”. Yet, importantly, children were not only pressured by the school’s curriculum structures but also by the culture to fit in, which included playing rugby. The children did not want to withdraw from activities due to the fear of looking inferior and un-­masculine to their peers (Pringle & Markula, 2005). The AfPE (2016, p. 143) states, “When consent is required for participation in organised activities  .  .  . the information provided to parents needs to be as comprehensive as possible in order for them to make informed decisions”. Unfortunately, on two occasions in recent years, the rugby authorities have been found to promote inaccurate and misleading information to stakeholders (including players and parents) about the levels of injury risk associated with rugby. For instance, Piggin and Pollock (2016) found that World Rugby disseminated inaccurate injury statistics in an infographic. Following this, Piggin and Bairner (2017) also found that England Rugby was using a quote that was misleading around the level of injury risk in rugby. When certain activities have a higher risk of injury than other sport, such as rugby (Roberts et al., 2013), informed consent is one mechanism for increasing the threshold of socially acceptable risk (Fuller, 2007). Fuller (2007, p. 185) comments: a high level of risk does not make a risk unacceptable per se; people will accept risks that are taken on a voluntary basis that are up to 1,000 times higher than risks taken on a non-­ voluntary basis. (Trimpop & Zimolong, 2012) As such, informed consent becomes a central feature of this debate (White & Robinson, 2018). Unfortunately, little information is shared with parents on the levels of injury and risk associated with youth contact rugby union. The latest studies to be published by the Rugby Football Union or their partners in the youth game are from the 2008–2009 season (Haseler et al., 2010), which is somewhat dated given the rate of change within injury, and particularly brain injury, research. In Australia, Boufous, Finch and Bauman (2004) found that over one-­quarter of parents were concerned about sporting activities that had a high risk of injury. Furthermore, a parent’s subjective perception of injury risk was correlated to injury data, showing that their risk assessments were legitimate. It is thus unsurprising that the sports that parents withdrew their children from the most were rugby league and rugby union (Boufous et al., 2004). As such, questions should be asked about why parents are currently not given the choice to remove their children from risky activities, such as contact rugby, from physical education and school sport in the United Kingdom. 99

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What makes a risk acceptable or not is somewhat contextually subjective (Quarrie et  al., 2017). Molcho and Pickett, however, have attempted to define some boundaries of unacceptable risk for children. Specifically, they suggest that: the following are deemed non-­acceptable: 1) Intentional injuries, 2) Severe or disabling injuries, 3) Injuries while involved in unhealthy, unnecessary, or abnormally risky behaviours, and 4) Injuries that occurred while ignoring known preventative measures. (Molcho & Pickett, 2011, p. 147) I and others have argued that rugby union meets all four of Molcho and Picketts’s criteria for an unacceptable risk for children (White et al., 2018b). In rugby, tackling is a structural element of play while also being the primary cause of injuries, making them an inevitable outcome of rugby participation (White et al., 2018b). Rugby can also lead to debilitating injuries, as a product of long-­term neurodegenerative disease linked to concussion. Given that rugby is not a mandatory element of the National Curriculum for physical education, it is not essential or necessary in a child’s education. Finally, given the low adherence to and uptake of rugby training courses and safety initiatives by those who deliver rugby both inside and outside of the school system, it is clear preventative strategies are being ignored.

The precautionary principle Barnett and O’Hagan (1997) developed the precautionary principle in the environmental setting, where there is often weak scientific understanding on a given topic. On occasions where the science is lacking, the burden of proof is placed upon the proponents of an activity to justify its safety (Barnett & O’Hagan, 1997). In practice, this means a more stringent standard is necessary on precautionary grounds, and only when proven safe are the standards relaxed. Martuzzi (2007, p. 569) comments: [the precautionary principle] is usually taken to state that lack of scientific certainty must not be used as a reason to ignore or postpone preventive or remedial action when there are other good reasons to do so. In this debate, given the extensive scientific research literature available for the risks and harms associated with contact rugby, the onus is on the rugby authorities to show why contact rugby is beneficial and safe for young people to participate in during physical education and school sport. Children are held to a higher safety standard than that held for adults in the United Kingdom, as they are deemed to be a particularly vulnerable group (HSE, 2020). As such, a cautionary approach is required when managing the safety and welfare of children and young people, particularly in non-­optional contexts like schooling. In the case of contact rugby, Bullingham, White and Batten (2017, p. 1450) suggest, “participation in tag or touch rugby acts in accordance with the cautionary approach when it relates to the risk of injuries for children”, and thus they suggest tag/touch forms should be implemented as an alternative to contact codes of rugby.

Conclusion Tackling in rugby in physical education and school sport has been a topic for wide debate in recent years (Pollock et  al., 2017; Quarrie et  al., 2017). Throughout this chapter, I  have explored the injury profile for contact rugby (Freitag et al., 2015; Roberts et al., 2013), showing 100

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it has a higher risk of injury comparative to other team sports (Roberts et al., 2013), including in the youth and school game (Archbold et al., 2017). Concussion accounts for a significant proportion of injuries in rugby union (Kirkwood et al., 2015), with the outcomes being debilitating and long term (Fralick et al., 2018; Li et al., 2017; Sariaslan, Sharp, D’Onofrio, Larsson & Fazel, 2016; Stewart et al., 2015). Current attempts to curtail concussion rates – whether that be through scrum caps, educational initiatives, or training regimes (such as the Activate programme)  – have thus far been ineffective (Pollock, White  & Kirkwood, 2017; White et  al., 2018a) and have often been focused on tertiary care rather than primary prevention of concussion (Batten et al., 2016). The national curriculum for physical education and school sport does not mandate the delivery of rugby, thus making it a choice for schools. Yet most often, schools make contact rugby a compulsory activity for boys (White, 2018). This is the same context whereby teachers are often not required to take, and most often have not undertaken, specialist training for teaching/coaching contact rugby (Pollock, White & Kirkwood, 2017). Furthermore, subject leaders for physical education and school sport also rate rugby union as the highest-­r isk activity delivered as part of the curriculum (White, 2018). In other countries, when parents are given the opportunity to remove their children from risky activities, such as contact rugby, they do so (Boufous et al., 2004). Of course, informed consent would need for accurate and reliable risk information to be shared with those offering their consent (White & Robinson, 2018), something both England Rugby and World Rugby have failed to do (Piggin & Pollock, 2016). Given that tackling in rugby meets some if not all four of Molcho and Pickett’s (2011) criteria for an unacceptable risk for children, tackling in rugby is unnecessary and unacceptable in the physical education and school sport curriculum (White et al., 2018b). Given what we already know about injury and concussion risk, the lack of informed consent, and the abysmal training requirements (and record), immediate precautionary action should be taken in order to maintain the welfare of young people in physical education and school sport. While I accept that the removal of the tackle may be detrimental to the identity of rugby, the removal of tackling is likely to be the most effective injury-­prevention strategy in this particular instance. Indeed, Cross and colleagues (2016, p. 4) state, “The most effective, although extreme, method for preventing concussion would be to eliminate exposure by removing the tackle from the game”. The sporting fraternity should be bold in removing the tackle from physical education and school sport to evidence that the health of our children is more important than a game.

Notes 1 The Sport Collision Injury Collective is an interdisciplinary group of academics and medical professionals who are concerned with injury in youth sport. Their work can be found at SportCIC.com. 2 The national governing body for rugby union in England. 3 An academy is a component of the player development pathway for rugby union in England. Here, youth players are recruited and developed due to their potential to compete in elite rugby. 4 The Health and Safety Executive is the regulator for health and safety in the United Kingdom. 5 The Rugby Football Union Code of Practice can be accessed at www.englandrugby.com/participation/ coaching/age-­g rade-­rugby/codes-­of-­practice 6 Simply put, this is a set of exercises and activities that are done before activity that prepare the muscles for physical activity.

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Anderson, E., McCormack, M.  & Lee, H. (2012). Male team sport hazing initiations in a culture of decreasing homohysteria. Journal of Adolescent Research, 27(4), 427–448. Archbold, H. A. P., Rankin, A. T., Webb, M., Nicholas, R., Eames, N. W. A., Wilson, R. K., Henderson, L. A., Heyes, G. J. & Bleakley, C. M. (2017). RISUS study: Rugby injury surveillance in Ulster schools. British Journal of Sports Medicine, 51(7), 600–606. Association for Physical Education (AfPE) (2016). Safe practice in physical education, school sport and physical activity. Worcester: AfPE by Coachwise. Barnett, V. & O’Hagan, A. (1997). Setting environmental standards: The statistical approach to handling uncertainty and variation. London: Chapman and Hall; CRC Press. Batten, J., White, A. J., Anderson, E. & Bullingham, R. (2016). From management to prevention: The new cure for sports concussion. British Journal of Sports Medicine, 50(21), 1293–1294. Benson, B. W., Hamilton, G. M., Meeuwisse, W. H., McCrory, P.  & Dvorak, J. (2009). Is protective equipment useful in preventing concussion? A systematic review of the literature. British Journal of Sports Medicine, 43(Suppl. 1), i56–i67. Black, A. M., Macpherson, A. K., Hagel, B. E., Romiti, M. A., Palacios-­Derflingher, L., Kang, J., Meeuwisse, W. H. & Emery, C. A. (2016). Policy change eliminating body checking in non-­elite ice hockey leads to a threefold reduction in injury and concussion risk in 11-­and 12-­year-­old players. British Journal of Sports Medicine, 50(1), 55–61. Bleakley, C. (2016, February 22). Research finds one in five schoolboy rugby injuries are to the head. The Irish Times. Retrieved from: www.irishtimes.com/sport/rugby/research-­finds-­one-­in-­five-­schoolboy-­ rugby-­injuries-­are-­to-­the-­head-­1.2544217?mode=print&ot=example.AjaxPageLayout.ot Bleakley, C., Tully, M. & O’Connor, S. (2011). Epidemiology of adolescent rugby injuries: A systematic review. Journal of Athletic Training, 46(5), 555–565. Boufous, S., Finch, C. & Bauman, A. (2004). Parental safety concerns: A barrier to sport and physical activity in children? Australian and New Zealand Journal of Public Health, 28(5), 482–486. Bullingham, R., White, A. & Batten, J. (2017). Response to “Don’t let kids play football”: A killer idea. British Journal of Sports Medicine, 51(20), 1450. Cantu, R. C. & Hyman, M. (2012). Concussions and our kids: America’s leading expert on how to protect young athletes and keep sports safe. New York: Houghton Mifflin Harcourt. Cross, M., Kemp, S., Smith, A., Trewartha, G. & Stokes, K. (2016). Professional rugby union players have a 60% greater risk of time-­loss injury after concussion: A 2-­season prospective study of clinical outcomes. British Journal of Sports Medicine, 50(15), 926–931. Department for Education. (2013). Physical education programmes of study: Key stages 3 and 4 national curriculum in England. Retrieved from: https://assets.publishing.service.gov.uk/government/uploads/ system/uploads/attachment_data/file/239086/SECONDARY_national_curriculum_-­_Physical_ education.pdf Fralick, M., Sy, E., Hassan, A., Burke, M. J., Mostofsky, E. & Karsies, T. (2018). Association of concussion with the risk of suicide: A systematic review and meta-­analysis. JAMA Neurology, 76(2), 144–151. Freitag, A., Kirkwood, G., Scharer, S., Ofori-­Asenso, R.  & Pollock, A. M. (2015). Systematic review of rugby injuries in children and adolescents under 21 years. British Journal of Sports Medicine, 49(8), 511–519. Fuller, C. W. (2007). Managing the risk of injury in sport. Clinical Journal of Sport Medicine, 17(3), 182–187. Fuller, C. W., Molloy, M. G., Bagate, C., Bahr, R., Brooks, J. H., Donson, H., Kemp, S. P. T., McCrory, P., McIntosh, A. S., Meeuwisse, W. H., Quarrie, K. L., Raferty, M. & Wiley, P. (2007). Consensus statement on injury definitions and data collection procedures for studies of injuries in rugby union. British Journal of Sports Medicine, 41(5), 328–331. Hall, R. C., Hall, R. C. & Chapman, M. J. (2005). Definition, diagnosis, and forensic implications of postconcussional syndrome. Psychosomatics, 46(3), 195–202. Haseler, C. M., Carmont, M. R. & England, M. (2010). The epidemiology of injuries in English youth community rugby union. British Journal of Sports Medicine, 44(15), 1093–1099. Health and Safety Executive (HSE). (2013). RIDDOR: Reporting of injuries, diseases and dangerous occurrences regulations 2013. Retrieved from: https://www.hse.gov.uk/riddor/ 102

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Health and Safety Executive (HSE). (2020). Vulnerable workers. Retrieved from: https://www.hse.gov.uk/ vulnerable-­workers/ Hislop, M. D., Stokes, K. A., Williams, S., McKay, C. D., England, M. E., Kemp, S. P. & Trewartha, G. (2017). Reducing musculoskeletal injury and concussion risk in schoolboy rugby players with a pre-­ activity movement control exercise programme: A cluster randomised controlled trial. British Journal of Sports Medicine, 51(15), 1140–1146. Kirkwood, G., Parekh, N., Ofori-­asenso, R. & Pollock, A. M. (2015). Concussion in youth rugby union and rugby league: A systematic review. British Journal of Sports Medicine, 49(8), 506–510. Li, Y., Li, Y., Li, X., Zhang, S., Zhao, J., Zhu, X. & Tian, G. (2017). Head injury as a risk factor for dementia and Alzheimer’s disease: A systematic review and meta-­analysis of 32 observational studies. PLOS ONE, 12(1), doi:10.1371/journal.pone.0169650 Malcolm, D. (2017). Sport, medicine and health: The medicalisation of sport? London: Routledge. Martuzzi, M. (2007). The precautionary principle in action for public health. Occupational and Environmental Medicine, 64(9), 569. McCrory, P., Meeuwisse, W., Dvorak, J., Aubry, M., Bailes, J., Broglio, S. et al. (2017). Consensus statement on concussion in sport: The 5th international conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine, 51(11), 838–847. McIntosh, A. S., Savage, T. N., McCrory, P., Fréchède, B. O. & Wolfe, R. (2010). Tackle characteristics and injury in a cross section of rugby union football. Medicine and Science in Sports and Exercise, 42(5), 977–984. McNamee, M. J., Partridge, B. & Anderson, L. (2015). Concussion in sport: Conceptual and ethical issues. Kinesiology Review, 4(2), 190–202. Meehan, W. P. (2011). Medical therapies for concussion. Clinics in Sports Medicine, 30(1), 115–124. Meehan, W. P. (2017). Concussions. Santa Barbara, CA: ABC-­Clio. Mez, J., Daneshvar, D. H., Kiernan, P. T., Abdolmohammadi, B., Alvarez, V. E., Huber, B. R. et al. (2017). Clinicopathological evaluation of chronic traumatic encephalopathy in players of American football. Jama, 318(4), 360–370. Molcho, M. & Pickett, W. (2011). Some thoughts about “acceptable” and “non-­acceptable” childhood injuries. Injury Prevention, 17(3), 147–148. Nyiri, P. (2015). The unknown risks of youth rugby. British Medical Journal, 350, h26. Omalu, B. I., DeKosky, S. T., Hamilton, R. L., Minster, R. L., Kamboh, M. I., Shakir, A. M. & Wecht, C. H. (2006). Chronic traumatic encephalopathy in a national football league player: Part II. Neurosurgery, 59(5), 1086–1093. Omalu, B. I., DeKosky, S. T., Minster, R. L., Kamboh, M. I., Hamilton, R. L. & Wecht, C. H. (2005). Chronic traumatic encephalopathy in a National Football League player. Neurosurgery, 57(1), 128–134. Oxfordshire Rugby Football Schools Union (2018). Training audit, October 2015. Retrieved from: www. oxonrugbyschools.co.uk/resources/ORFSU%20Training%20Report%20Dec%202015%20.pdf Palmer-­Green, D. S., Stokes, K. A., Fuller, C. W., England, M., Kemp, S. P.  & Trewartha, G. (2013). Match injuries in English youth academy and schools rugby union: An epidemiological study. The American Journal of Sports Medicine, 41(4), 749–755. Pfister, T., Pfister, K., Hagel, B., Ghali, W. A. & Ronksley, P. E. (2016). The incidence of concussion in youth sports: A systematic review and meta-­analysis. British Journal of Sports Medicine, 50(5), 292–297. Piggin, J.  & Bairner, A. (2017, May  23). An urgent call for clarity regarding England Rugby’s injury claims. Idrotts Forum. Retrieved from: https://idrottsforum.org/feature-­piggin-­bairner170523/ Piggin, J.  & Pollock, A. (2016). World Rugby’s erroneous and misleading representation of Australian sports’ injury statistics. British Journal of Sports Medicine, 51(15), 1108. Pollock, A. M. (2014). Tackling rugby: What every parent should know about injuries. London: Verso Books. Pollock, A. M., White, A. J. & Kirkwood, G. (2017). Evidence in support of the call to ban the tackle and harmful contact in school rugby: A response to World Rugby. British Journal Sports Medicine, 51(15), 1113–1117. Pringle, R. & Markula, P. (2005). No pain is sane after all: A Foucauldian analysis of masculinities and men’s rugby experiences of fear, pain, and pleasure. Sociology of Sport Journal, 22(4), 472–497. 103

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Quarrie, K. L., Brooks, J. H., Burger, N., Hume, P. A. & Jackson, S. (2017). Facts and values: On the acceptability of risks in children’s sport using the example of rugby: A narrative review. British Journal Sports Medicine, 51(15), 1134–1139. Roberts, S. P., Trewartha, G., England, M., Shaddick, G. & Stokes, K. A. (2013). Epidemiology of time-­ loss injuries in English community-­level rugby union. BMJ Open, 3(11), doi:10.1136/bmjopen-­2013-­ 003998 Sariaslan, A., Sharp, D. J., D’Onofrio, B. M., Larsson, H. & Fazel, S. (2016). Long-­term outcomes associated with traumatic brain injury in childhood and adolescence: A nationwide Swedish cohort study of a wide range of medical and social outcomes. PLoS Medicine, 13(8). doi:10.1371/journal.pmed.1002103 Smith, A., Thurston, M., Lamb, K. & Green, K. (2007). Young people’s participation in national curriculum physical education: A study of 15–16 year olds in north-­west England and north-­east Wales. European Physical Education Review, 13(2), 165–194. Spinks, A. B.  & McClure, R. J. (2007). Quantifying the risk of sports injury: A  systematic review of activity-­specific rates for children under 16 years of age. British Journal of Sports Medicine, 41(9), 548–557. Stewart, W., McNamara, P. H., Lawlor, B., Hutchinson, S.  & Farrell, M. (2015). Chronic traumatic encephalopathy: A potential late and under recognized consequence of rugby union? QJM: An International Journal of Medicine, 109(1), 11–15. Taylor, K. M., Kioumourtzoglou, M. A., Clover, J., Coull, B. A., Dennerlein, J. T., Bellinger, D. C. & Weisskopf, M. G. (2018). Concussion history and cognitive function in a large cohort of adolescent athletes. The American Journal of Sports Medicine, 46(13), 3262–3270. Trimpop, R. & Zimolong, B. (2012). Risk acceptance. In Stellman, J. M. (Ed.), Encyclopaedia of occupational health and safety (4th ed.). Retrieved from: www.ilo.org/encyclopedia/?hdoc&nd=857000002 Tucker, R., Raftery, M., Fuller, G. W., Hester, B., Kemp, S. & Cross, M. J. (2017). A video analysis of head injuries satisfying the criteria for a head injury assessment in professional rugby union: A prospective cohort study. British Journal of Sports Medicine, 51(15), 1147–1151. Tucker, R., Raftery, M.  & Verhagen, E. (2016). Injury risk and a tackle ban in youth rugby union: Reviewing the evidence and searching for targeted, effective interventions – A critical review. British Journal of Sports Medicine, 50(15), 921–925. Van Mechelen, W., Hlobil, H. & Kemper, H. C. (1992). Incidence, severity, aetiology and prevention of sports injuries. Sports Medicine, 14(2), 82–99. Viviers, P. L., Viljoen, J. T. & Derman, W. (2018). A review of a decade of rugby union injury epidemiology: 2007–2017. Sports Health, 10(3), 223–227. White, A. J. (2018). An interdisciplinary exploration into whether tackling should be banned from rugby in school physical education. Unpublished PhD thesis, University of Winchester, UK. White, A. J., Batten, J., Kirkwood, G., Anderson, E. & Pollock, A. M. (2018a). Pre-­activity movement control exercise programme to prevent injuries in youth rugby: Some concerns. British Journal of Sports Medicine, 53(9), 525. White, A. J., Batten, J., Robinson, S., Anderson, E., Burns, A., Batey, J., Ryan-­Stewart, H.  & Discombe, R. (2018b). Tackling in physical education rugby: An unnecessary risk? Injury Prevention, 24(2), 114–115. White, A. J. & Franks, B. (2019). Film review: Concussion. International Review for the Sociology of Sport. doi:10.1177/1012690219839909 White, A. J. & Robinson, S. (2018). Consent and brain trauma in schools. Journal of Physical Education, Recreation and Dance, 89(4), 5–6. White, A. J., Robinson, S., Anderson, E., Bullingham, R., Pollock, A. & Scoats, R. (2019). The lack of age representation in the governance of rugby union in England. Sociology of Sport Journal, 1–34, doi:10.1123/ssj.2018-­0149

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9 Welfare and the protection of young athletes An analysis of the nature and prevalence of bullying behaviours in sport settings Miguel Nery, Carlos Neto, António Rosado and Peter K. Smith

Introduction An examination and understanding of power dynamics in youth sport is important for sports coaches, administrators and parents, and all those who work with athletes and share responsibilities for their overall well-­being (Fisher & Dzikus, 2010). Although a considerable amount of research has been conducted about violence in sport (see, for example: Fields, Collins & Comstock, 2010; Ibáñez, Marco, Pablo  & Ibáñez de Elejalde, 2012), few studies have specifically regarded bullying in this context. However, the limited research available indicates a significant amount of bullying occurs in youth sports. Besides approximately 1 in 10 athletes being victimised, many others are involved in bullying as bystanders and/or bullies. These athletes may also suffer from the consequences of being involved in repeated episodes of peer aggression. In this particular setting, victims tend to drop out earlier from sport practice due to bullying (Evans, Adler, MacDonald & Côté, 2015). It is therefore crucial to develop research and interventions on bullying in sport in order to enhance the quality of the sport experience for athletes. In this chapter, we analyse the nature and prevalence of bullying behaviours in youth sport. To do so, we first consider the nature of power dynamics and how these can be abused. This leads to a consideration of the definition of bullying, a description of its various forms, the roles of the participants involved, and some of the settings in which most research has been carried out. We then reflect on the nature of sport and its culture and why it is important to study bullying within this particular context. We review some main findings from the international studies on bullying in sport, including our own nationwide study in Portugal. Finally, some practical implications are presented.

Power dynamics Human relations and social co-­existence are based on social norms and power dynamics. The hierarchies and roles played by each element of a community influence the way individuals 105

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are perceived within groups and have a strong influence on social interactions with other members. Power dynamics are not a problem per se; however, when they become perverse and coercive dynamics, based on systematic abuse by one or more powerful individuals towards others more vulnerable and unable to defend themselves, we may be talking about bullying. Considering this, it is easy to understand why the topic of bullying is as old as humans and such a great challenge. Different types of abusive power dynamics have always existed, and there are different ways to exert power and dominance, depending on the social setting and people involved.

Understanding bullying Coercive power dynamics are multiple and have always been present in human relations. Among these, some types can be labelled bullying. A specific and detailed definition, largely accepted by researchers, is that bullying is intentionally aggressive behaviour among peers, with repetition, and a power imbalance between victims and aggressor such that it is difficult for victims to defend themselves (Gladden, Vivolo-­Kantor, Hamburger & Lumpkin, 2014; Olweus, 1995). This definition restricts bullying to among peers; many researchers accept this, but others are prepared to consider, for example, in the school context, teacher–pupil or pupil–teacher bullying (in addition to student–student bullying or teacher–teacher bullying, which would be a form of workplace bullying). In sport, some coaches use systematic abusive coaching practices based on the power imbalance existing between them and the athletes they work with. This dynamic is similar to that of bullying, with the exception that it does not occur between peers. Research has labelled this emotional abuse (Stirling, 2013) and defined it as: “a pattern of deliberate non-­contact behaviours by a person within a critical relationship role that has the potential to be harmful [to an individual’s emotional well-­being]” (Stirling & Kerr, 2008, p. 178). We can consider the differences between bullying and emotional abuse. From a legal point of view, although in the United Kingdom there is no legal definition of bullying and these episodes are not considered a crime, acts of bullying may well fall within the wider concept of child emotional abuse, which is considered a criminal act when it results in harm to the targeted child. The World Health Organisation (World Health Organisation and the International Society for the Prevention of Child Abuse and Neglect, 2006) also defines emotional abuse in very similar terms to bullying, dividing these two concepts based on whether the episodes occur between peers or others. Although we acknowledge that this conceptual discussion is warranted and is still active among the scientific community, here we refer to bullying as a systematic abusive pattern of behaviour that occurs between peers.

Types Bullying behaviours are often put into different categories, depending on the type of behaviours associated with each. A possible categorisation is shown in Figure 9.1. The term traditional bullying refers to bullying behaviours offline  – the only kind studied before the existence of the Internet. This remains a major problem and a focus of attention for researchers. However, this century has seen the rise of online or cyber-­bullying, performed via mobile phones and the Internet (see Kavanagh, Litchfield & Osborne’s chapter in this collection for more on this). This has some particular features, including more easily allowing perpetrators to remain unidentified, faster dissemination of the abusive behaviours to a wide audience, and difficulty in escaping from victimisation (Kowalski, Giumetti, Schroeder & Lattanner, 2014). All 106

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Verbal: mocking, insulting, teasing, put-downs, constant criticism, calling names, using sarcasm to be cruel; Traditional (or offline) bullying Physical: physical abuse, hitting, intimidating, being taunted, tortured, or beaten up;

Social/relational: spreading rumours, encouraging Main types

others to avoid a certain person.

Cyber-stalking,

posting

hurtful

things

about

someone on social media, spreading rumours or Cyber- (or online) bullying

gossip about someone online, password theft, pretending to be another person by creating a fake online profile, taking an embarrassing photo or video and sharing it without permission.

Figure 9.1  The main forms of bullying behaviour.

the previous types of bullying behaviour may be involved in what is often called ‘bias bullying’, or ‘identity-­based bullying’, which consists of bullying against specific groups based on an aspect of their identity. There are other more general taxonomies that divide bullying into two main categories (Smith, 2014). Examples are: • •

• •

Direct vs. Indirect: Direct bullying happens when bullies and victims are directly involved, while in indirect bullying, there is no direct confrontation between bully and victim; Hostile vs. Instrumental: Hostile bullying refers to attacks with no apparent reason, contrasting with instrumental bullying, which has specific purposes and is a means for achieving these (i.e. access to resources); Pro-­active vs. Reactive: In pro-­active bullying, the bully initiates the attack spontaneously, while in reactive bullying, this is in response to a previous attack that was suffered; Individual vs. Group: Individual bullying is a one-­to-­one situation in which bystanders observe without acting, while in group bullying, bystanders may join in the bullying.

The categories presented here are some possible taxonomies and serve some theoretical purposes. 107

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Ringleader bullies: instigate bullying; Bullies Assistants or reinforcers: encourage and/or join bullying. “Pure” victims: individuals who are targeted; Participants

Victims

Bully-victims: Have some of the features of both bullies and victims. These individuals may alternate these roles. Defenders: intervene and support victims;

Non-involved

Bystanders: observe without taking further action; Outsiders: do not see what is going on.

Figure 9.2  A taxonomy of participants in bullying episodes.

Roles Bullying episodes are performed by different types of participants. A possible categorisation is provided in Figure 9.2. Although some individuals are more prone to become victims, bullies, or bully-­victims due to their behavioural standards, anybody can be targeted as a victim or become a bully at some point.

Social settings The first research on bullying was focused on children in school settings (i.e. Olweus, 1995). This is still the major focus of bullying research. However, other contexts have also been a focus of attention. A  review (Monks et  al., 2009) and an edited volume (Monks  & Coyne, 2011) specifically reviewed research on bullying in different contexts. However, no contribution on bullying in sport can be found in these.

Bullying in sport The importance and social impact of sport are recognised worldwide. Sport is an ancestral human cultural production. It derives from play and can be enacted within a ritualised setting (Renfrew, 2017). Sport practice allows humans to enact wars and confrontations in a playful scenario, to attack opponents and avoid being attacked, to cooperate with teammates, and to compete with peers. It allows athletes to transcend themselves by bettering their previous achievements. When this experience is lived properly, it enhances an individual’s physical and psychological development by strengthening ego functions (Twemlow et al., 2008). At a group level, it contributes to cooperative teamwork and can help the social integration of excluded populations. A good example of the contribution of sport to the promotion of inclusion was the role it played in South Africa, when the national rugby team played an important role in the post-­Apartheid period (Bersell, 2017) – a contribution that continued when they won the Rugby World Cup again in 2019. 108

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Sport is usually perceived as a social good, and its practice among youngsters is often promoted by parents, teachers, and health professionals. However, sport practice by itself does not necessarily result in positive outcomes. There can be dark sides to sport that should not be ignored, as the chapters in this compilation attest. Examples include overtraining, coach abuse (Stirling, 2013), sexual harassment and abuse (Brackenridge, 2001), and bullying (Ventura et al., 2019). Research has highlighted that if unsuitable, activities and programmes based on sport may have a detrimental effect on youngsters. How programmes are developed and by whom are factors important for their success enhancing youngsters’ social skills, because merely participating in sports isn’t a guarantee for young athletes to benefit from its potential in human development (Andrews & Andrews, 2003). Although sport practice may promote the development of social skills, it may also induce aggression and contribute to increasing the prevalence of bullying (Escury & Dudink, 2010). In their research on violence and sport, Endresen and Olweus (2005) examined a group of sports they labelled ‘power sports’, which included a range of combat sports such as boxing, wrestling, and martial arts. They concluded that the involvement of youngsters in these may promote an increase in anti-­social behaviour outside sport clubs. Coach abuse also falls into the category of unacceptable sporting practices. Some coaches have an autocratic and abusive style of coaching and argue this is for the good of their athletes, as it promotes toughness and resilience (Palframan, 1994). Many athletes and their parents perceive these tactics as a normal and acceptable part of sport, with the intention of improving athletes’ performances (Fisher & Dzikus, 2010). The focus on performance above all, and the acculturation of sport norms from both athletes and their parents during an athlete’s career, may contribute to athletes and their parents not perceiving these abusive relations as negative. However, later reflections near (or in) the retirement phase, during which emotional distance may allow athletes to better analyse their experiences, often leads to the acknowledgement that such behaviours were abusive. This may also lead to negative consequences for athletes due to exposure to the behaviours over many years (Stirling & Kerr, 2009). In summary, sports may be a tool with high potential for developing social skills; however, the quality of sport experience depends on several factors, and engagement in sport activities isn’t necessarily positive per se. Research on bullying in sport involves the analysis of power dynamics between peers in this setting. To better understand the nature of such behaviours, it is important to consider sports culture or the sporting ethos, which is different from that in the school setting, where the emphasis is on individual academic attainment.

The nature of bullying in sport Understanding the nature of sport culture helps to explain the nature and prevalence of bullying behaviours in this particular context, but it cannot fully explain bullying, and more factors must be considered. An analysis of the profiles of victims and bullies is important to understand systematic peer abuse. Both bullies and victims tend to enact the same roles in other social settings. For example, regarding youth sport and school, Escury and Dudink (2010) found a considerable overlap of bullying behaviours among youngsters in both school and sport settings. This suggests some behavioural stability derived from the individuals’ own profile. Those who bully are typically described as dominant, confrontational, and more physically apt for sport, while those who are victimised are often lower-­performance athletes who are relatively shy and isolated and have a tendency to avoid conflict (Olweus, 2010). Approaching bullying as a group process may also be insightful. Bullying is often a way to show dominance within a peer-­group situation. This approach focuses on how group processes influence peer-­g roup behaviours and considers the motivation of bullies, the lack of support 109

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often provided to victims, and the important role of bystanders, who can decrease or increase the frequency of bullying depending on how they react. Bullying is more likely to occur in the early stages of peer-­group formation, when the creation of social status and each member’s role are not yet clearly defined (Pellegrini & Long, 2002). This is because bullying may be used to achieve dominance and high social status within a peer group. Social pressure acts to encourage individuals to behave according to the prevailing norms and perceived expectations. As such, the need for acceptance and approval by peers, especially in adolescence, may lead some youngsters to behave aggressively and to target those who are perceived as less popular. Understanding bullying as a result of a group process serves to consider bullying a goal-­oriented kind of aggressive behaviour. Interventions to deal with it should therefore include actions targeted at the peer-­group level (Salmivalli, 2010).

International research on bullying in youth sport: Key findings The competitive nature of sport often promotes and increases peer aggression. In Catalunya, Spain, Ventura and colleagues (2019) conducted research on bullying among young football players. They surveyed 1,972 young athletes (age range 10 to 14 years old) from both sexes (223 female and 1,739 male), using a questionnaire developed by our team.1 This survey data was complemented by focus group interviews with sport stakeholders. From the total sample, 9% of the athletes reported having been victimised. Bullying tended to occur mostly in multiple types combined (60.8%), which means that athletes were targeted by more than one type of bullying behaviour considered in the questionnaire (i.e. verbal and social bullying). However, when victims experienced only one type of bullying (39.2%), it was mostly verbal in nature (33.2%). Although less often reported, physical (4.6%), social (0.8%), and cyber-­bullying (0.6%) were also reported. The changing room was identified as a key location where bullying occurs, perhaps because it is less supervised by adults. Youngsters’ engagement in bullying behaviours may overlap between school and sports club; some youngsters are victimised in both settings (Escury & Dudink, 2010; Ventura et al., 2019). Some research has also focused on the relation between bullying in school and in sports club by analysing the influence of sport practice as a protective factor against school bullying. The results were not positive. For example, in Canada, Volk and Lagzdins (2009) found that adolescent female athletes reported higher levels of school bullying when compared to non-­athlete female students in a school setting. These results suggest that being an athlete may contribute to being targeted among girls. A study conducted in Portugal by Melim and Oliveira (2013) found involvement in sport had no relationship with levels of victimisation in school. Gender may help to understand the differences here. Volk and Lagzdins (2009) only considered female athletes in their study, and, according to López-­Albalá (2016), those who do not conform to traditional gender roles in sport are more prone to be questioned regarding their gender identity and sexual orientation, which may carry over into the school setting. Some research has highlighted possible misperceptions around bullying, helping to explain what appears to be the lower prevalence of bullying in sport compared to in schools. In Canada, Volk and Lagzdins (2009) considered the impact of the normalisation of aggressive behaviours in sport by suggesting that bullying in sport may be under-­reported due to it being perceived as regular sports aggression rather than abusive peer aggression. Stirling and colleagues (2011), also from Canada, describe how the celebration of mental toughness in sport may make breaking the silence about being a victim of bullying more difficult, as speaking out may be seen among athletes as a sign of weakness. As a result, victims tend to remain silent about bullying and are more prone to suffer from early drop-­out from sport as a result of being victimised (Ventura et al., 2019). 110

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Our research in Portugal In Portugal, we conducted research that aimed to describe and analyse the prevalence and nature of bullying in youth sports and to establish a baseline for the prevalence of such behaviours (Nery, Neto, Rosado & Smith, 2019, 2020). We carried out a nationwide survey in 2016 with male athletes from nine different sports: volleyball, football, rugby, handball, gymnastics, swimming, athletics, judo, and wrestling. Data collection took place in 97 sport clubs across mainland Portugal, with 1,458 young male athletes (aged 10–19 years old) participating in a questionnaire that collected data about their bullying experiences as victims, bystanders, and bullies. This was the first national attempt to study bullying among young athletes in Portugal. Female athletes were excluded from our study; this is clearly a limitation of our research, and the nature of bullying in girls’ sports clubs deserves more attention in future research. The variables considered for victimisation were the frequency of bullying episodes, their duration, location, the types of bullying experienced, the number of peers involved, the activities being undertaken when the bullying occurred, participants’ feelings about bullying, the coping strategies victims used, whom victims spoke to about bullying episodes, who approached bullies about bullying, and victims’ sources of support (coach, family, and peers). Bystanders were asked about the types of bullying witnessed, their reactions towards witnessing bullying, their feelings about bullying, and the reasons they ascribed for the bullying occurring. Finally, bullies were asked how frequently they engaged in bullying, the number of peers involved, the types of bullying engaged in, their feelings about bullying, and about who had talked to them about bullying.

Frequency of bullying The results showed that bullying in youth sport was not infrequent and is certainly a concern. Altogether, 56% of the athletes reported being involved as a victim, bystander, and/or bully, while the remaining 44% reported no involvement at all. Of those who had experience of bullying, 10% reported being a victim (defined as a victimisation frequency of at least one to two times since the beginning of the season), 11.3% reported being bullies (defined as being involved in episodes as a bully at least one to two times since the beginning of the season), and 34.6% reported being bystanders (defined as having seen peers being victimised by some type of bullying behaviour since the beginning of the season). In some cases, athletes got involved in more than one role, with 2.7% being bully-­victims, 6.1% being victim-­bystanders, 9.2% being bully-­bystanders, and 2.4% reporting being involved as victims, bullies, and bystanders. The time period considered was two months previous to the beginning of the sport season.

Types of bullying The analysis of types of bullying reported by victims, bullies, and bystanders showed that verbal bullying (mainly mocking and insults) was the most prevalent type (for victims 45.9%, for bullies 59.6%, and for bystanders 44.8%). Although less frequent, social bullying, namely ignoring and excluding victims, was also commonly reported by those who were victimised (23%), by those who participated as bullies (11.6%), and by bystanders (17.6%). The prevalence of physical bullying was low, with overt physical aggression such as pushing, punching, or kicking, seldom occurring – bullies reported only 9.6% of instances of physical bullying, while victims (8.2%) and bystanders (7.1%) also reported a lower prevalence of these behaviours compared with other forms. Cyber-­bullying was the least common type of bullying behaviour reported by victims (1.6% of instances), by bullies (4.1% of instances), and by bystanders (2.6% of instances). No 111

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significant differences were identified regarding the prevalence of victimisation based on the age of the athlete or the type of sport (individual, team, or combat).

Reporting and bystanding behaviour The results also suggested that most victims remained silent about being bullied (49.1%). Peers are the ones to whom victims most often disclose their experience (26.7%), and those who did generally felt it resulted in a positive outcome (45.5%). As for the reactions of bystanders, those who disliked bullying were more prone to stand by victims and defend them from bullies, while those who reported being indifferent to bullying tended not to interfere and, in a minority of cases, even joined in with the bullying.

Comparison of the prevalence of bullying between school and sports club The rates of bullying in school and sport are very similar. However, the baseline value for the prevalence of bullying in sport should be analysed with caution; some who have previously conducted research on bullying in sport consider the victimisation rates could actually be higher than reported: victims are more likely to drop out of sport early due to being bullied (Evans et al., 2015), and, as a result, when data is collected, they may no longer be at a sports club. To complement the statistical data, we also conducted qualitative research to better understand the nature of bullying behaviours, interviewing 127 athletes, 32 coaches, and 9 former elite athletes. These results corroborate the hypothesis that athletes who are victims of bullying often leave sport as a result of their experience, although some victims changed clubs and/or sport as a way to avoid victimisation rather than leaving sport altogether. This strategy is an effective way to manage being victimised for those who still want to practise sport but feel unwelcome within a specific group of peers. Another factor that may contribute to lower rates of reported victimisation in sport is the normalisation of aggression in sports. The nature and culture of sport result in the normalisation of certain bullying behaviours, whereby bullying behaviours come to be considered acceptable, ‘part of the game’, and thus are not reported. The win-­at-­all-­costs ethos of sport may further serve to normalise bullying behaviours (e.g. behaviours that are intended to exclude individuals) rather than to promote cooperation and the development of social skills, since when victory is prioritised, bullying may be seen as another justifiable way to achieve this.

Verbal aggression Our findings suggest that verbal bullying was more prevalent than social, physical, and cyber-­ bullying (46% of victims reported being victims of verbal bullying) (Nery et al., 2019). These quantitative results were complemented by in-­depth data collected through interviews with young athletes and their coaches. Our results suggest young athletes seem to be immersed in a sports culture that reflects negative attitudes towards those who do not conform to conventional social norms. For example, the coaches referred to verbal bullying episodes in which athletes mocked and insulted their peers, while the athletes described the content of verbal bullying episodes between themselves, highlighting that these included jokes about low sport performance and body issues such as being overweight or lacking coordination. Sexual jokes were also frequently described, especially the use of homophobic remarks, regardless of their peers’ sexuality. Some authors have described homophobic abuse in sport as a way for young athletes to attack 112

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those whom they consider different (Brackenridge, Rivers, Gough & Llewellyn, 2007; Rivers, 2010). Codes of conduct and educational interventions may be useful here.

Location Our study found that bullying occurred mainly inside the sport club (71.8%). Further data collected through athlete interviews suggested that the hot spots for bullying behaviours are mainly those areas less supervised by adults, especially the changing room. These results corroborate previous research (Evans et al. 2015). Less frequently, athletes also referred to training areas (i.e. the pitch, pool, or gym) as places where bullying occurred (Ventura et al., 2019). Changing rooms are private areas for athletes. Here they are able to freely interact with one another, away from adult supervision. It is important for youngsters to have their privacy and the space to interact among themselves without adult supervision. However, changing room supervision must be considered, even though it may not necessarily involve including the presence of an adult; peers can learn how to regulate their behaviour by supporting one another, and team captains (usually leaders) may play an important role here.

Reasons for bullying There are many reasons victimisation occurs. Data from interviews with coaches and athletes helped us understand what motivated athletes to bully. We divided the reasons for bullying into three main categories: 1) fundamental reasons, 2) peer pressure, and 3) individual characteristics (see Table 9.1). Coaches explained bullying based on fundamental reasons, while athletes Table 9.1  Reasons for bullying. Category

Reason

Description

Fundamental reasons

1. Abuse of perceived power 2. Hierarchy

To target a teammate as a way to raise the social status of the perpetrator within peer group.

3. Envy 4. Rivalry Peer pressure

5. Divergence from standard 6. Imitation

7. Victim responsibility Individual characteristics

8. Low sport performance 9. Body 10. Personality

Older and higher social status athletes exert abusive power over new incomers and justify their behaviour based on their social status and antiquity in the sport club. Bullying based on envy of the perpetrators. Bullying based on peer sportive rivalry. Bullying based on the perceived difference of the victim from the accepted standards of the peer group. Perpetrators imitate bullying behaviours to be accepted and valued by other teammates who are also bullies (and have high status). Bullying justified by the way victims interact with peers that contributes to their victimisation. Bullying based on targeting low-performance athletes, due to their lack of ability to perform sports. Bullying based on body issues such as overweight or lack of coordination. Bullying based on different way of thinking or acting of the victims that makes them be perceived by others as a misfit.

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provided further information and also explained bullying episodes based on peer pressure and individual characteristics. The perpetrators of bullying tend to attack those who are perceived as more vulnerable and passive, those with fewer friends, or those who have less physical ability and/or lower performance. These are ‘safe’ targets to attack, and bullies may gain self-­esteem and status from within their peer group by bullying. Athletes who diverge from accepted standards are also more prone to be bullied. Coaches should be aware of these risk factors to prevent victimisation of more vulnerable athletes and to promote tolerance among athletes. Peer pressure and the desire of most of adolescents to be accepted and to feel part of their peer group also influence behaviour and may promote acceptance of bullying behaviours unless this is actively challenged.

Who victims speak with and sources of support We found, as many other studies have, that victims tend to remain silent about their victimisation (Ventura et al., 2019). Some of the reasons for this have been previously noted, namely the fact that talking about being bullied may be perceived as weak, with victims seen as unable to handle the situation themselves (Smith, 2014). Meanwhile, the behaviour of bystanders depends heavily on their own attitude towards bullying, their status within the peer group, and on how they think peers might respond if they intervene. The data collected from those who were bullying bystanders shows a significant relationship between feelings towards bullying and reasons ascribed for it and also between feelings towards bullying and the reactions of bystanders. The data suggests that bystanders who considered the bullies responsible for the bullying more often reported negative feelings towards bullying and were more likely to defend victims, while bystanders who considered victims responsible for the bullying more often reported being neutral towards bullying and were more likely to observe without intervening. A minority of bystanders who reported feeling neutral towards bullying also joined the bully and became perpetrators. These findings suggest the need to promote peer-­support systems and to encourage bystanders to act on victims’ behalf.

Consequences of being victimised Bullying has serious consequences for those involved, especially for victims. Besides social rejection, increased anxiety, and reduced self-­esteem (just as results from school bullying), our research suggests athletes who are targeted tend to avoid the changing room and develop a negative attitude towards sports practice. As a result, athletes may abandon sport due to their experience of being bullied. These findings are consistent with those of other researchers (Stirling, Bridges, Cruz & Mountjoy, 2011). Early and preventative intervention is needed to avoid victims withdrawing from sport.

Some general guidelines The guidelines presented here serve as examples for possible interventions. To efficiently prevent and tackle bullying, a holistic approach must be considered. Anti-­bullying programmes are more than a list of isolated strategies. To be efficiently implemented, it is important to educate the adults responsible for sport training about bullying and about the programmes available.

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Working with coaches and sport leaders • • • •

•

Sensitise coaches to the need to address and prevent bullying, Discuss how the normalisation of bullying and other types of aggressive behaviours happens in sport, Sensitise sport agents to the consequences of bullying for victims, Discuss and implement possible strategies to prevent bullying within sport clubs (i.e. codes of conduct, efficient supervision of areas more prone to the occurrence of bullying episodes, developing an anti-­violence culture in sports clubs), Learn how to tackle bullying episodes (i.e. sanctions, restorative justice, or non-­punitive methods)2 and to promote peer support.

Working with parents • •

Learn how to identify signs of possible victimisation, Learn support strategies (i.e. recognise the suffering of victims, emphasise that things can change) and learn what to avoid doing if your child is being bullied (i.e. don’t blame them, don’t talk with the coach without consulting them).

Working with athletes • • •

Discuss the difference between bullying and ‘banter’, Learn how to properly identify bullying behaviours, Sensitise bystanders to the feelings of victims (i.e. role-­play being a victim). Provide ways of intervening positively to defend victims. Bullying is everyone’s problem, and bystanders have an important role to play in dealing with it.

Concluding remarks To efficiently prevent and tackle bullying in sport, different levels of intervention must be considered. At a macro level, governments should consider developing national educational policies that include addressing bullying and a focus on athlete welfare and that also make reference to existing legal frameworks on child abuse. A lower level of prevention and intervention should focus on society, especially on the media and the sport industry, which exert considerable influence on the behaviour of sport stakeholders. There is a need to foster messages condemning violence, abuse, and discrimination in sports through these channels. Campaigns can be useful here. Sport agencies also have an important role at this level. These should promote the development of intervention projects to study, prevent, and tackle bullying. Working with parents is also very important. Parent–coach meetings should take place throughout the season to discuss issues such as sporting plans and pedagogical approaches and/ or to foster the cooperation of parents. In some cases, including parents in activities (i.e. accompanying children during travel) to enhance parental involvement in the club may also be beneficial. Recently, some sport clubs have also started ‘schools’ for parents that aim to help parents get more involved and contribute positively to their child’s sport experience. Finally, to address bullying and other forms of abuse in sport, there are many other important options to consider within sport clubs. Individual interventions could be made with victims

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(i.e. assertiveness training), with bullies (i.e. a meaning roles approach), and with bystanders (i.e. programmes to encourage bystanders to intervene on behalf of victims). Some of these interventions must be performed by a qualified psychologist. Coaches should also receive proper training to address bullying and have access to anti-­bullying information through, for example, newsletters or information booklets. Regulations and norms in sports clubs are also important to establish and regulate acceptable and unacceptable behaviours, and codes of conduct may be helpful tools here. It’s also important that clubs monitor the areas where bullying is more prone to occur and develop forums, such as club councils, where such problems can be discussed. Other suggestions to address bullying in sport include reviewing criteria for the selection and evaluation of coaches (i.e. asking for criminal record checks and including issues beyond only sports performance on coaches’ annual evaluation), developing policies on athlete welfare that include bullying, implementing procedures for reporting bullying, and offering education and training on bullying for athletes. Although reactive strategies may be necessary to tackle more prevalent bullying behaviours, peer-­support schemes, such as peer mentoring or mediation, should be considered to prevent bullying. Bullying can be dealt with efficiently. However, to do so, it is necessary to adopt different forms of intervention and include different stakeholders who share the common goal of making youth sport more inclusive and healthy.

Notes 1 The questionnaire was previously used in research conducted in Portugal by the authors of this chapter. The use of this questionnaire by Ventura and colleagues is due to the lack of research on this topic and of validated instruments for this topic. It allowed a comparison of the results from both countries regarding the prevalence of bullying among young athletes. 2 Non-­punitive methods aim to change aggressive behaviours but to avoid using punishment to achieve this (i.e. the method of shared concern or support group method).

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Gladden, R. M., Vivolo-­Kantor, A. M., Hamburger, M. E. & Lumpkin, C. D. (2014). Bullying surveillance among youths: Uniform definitions for public health and recommended data elements, version 1.0. Atlanta, GA: National Centre for Injury Prevention and Control, Centres for Disease Control and Prevention and US Department of Education. Ibáñez, A. S., Marco, F. G., Pablo, H. G. & Ibáñez de Elejalde, B. G. (2012). Prevención de la agresividad y la violencia en el deporte en edad escolar: Un estudio de revision. Cuadernos de Psicología del Deporte, 12, 57–72. Kowalski, R. M., Giumetti, G. W., Schroeder, A. N. & Lattanner, M. R. (2014). Bullying in the digital age: A critical review and meta-­analysis of cyber-­bullying research among youth. Psychological Bulletin, 140, 1073–1137. López-­Albalá, E. (2016). Mujeres deportistas espanolas: Estereotipos de género en los medios de comunicación. Sociologiados. Revista de Investigación Social, 1(2), 87–110. Melim, F. & Oliveira, B. P. (2013). Prática desportiva, um meio de prevenção do bullying na escola? Porto Alegre, 19(2), 55–77. Monks, C. & Coyne, I. (Eds.). (2011). Bullying in different contexts. Cambridge: Cambridge University Press. Monks, C., Smith, P. K., Naylor, P., Barter, C., Ireland, J. & Coyne, I. (2009). Bullying in different contexts: Commonalities, differences and the role of theory. Aggression and Violent Behaviour, 14, 146–156. Nery, M., Neto, C., Rosado, A. & Smith, P. K. (2019). Bullying in youth sport training. A nationwide exploratory and descriptive research in Portugal. European Journal of Developmental Psychology, 16(4), 447–463. Nery, M., Neto, C., Rosado, A. & Smith, P. K. (2020). Bullying in youth sports training: New perspectives and practical strategies. London: Routledge. Olweus, D. (1995). Peer abuse or bullying at school: Basic facts and a school-­based intervention programme. Prospects, 25(1), 133–139. Olweus, D. (2010). Understanding and researching bullying: Some critical issues. In Jimerson, S., Swearer, S. & Espelage, D. (Eds.), Handbook of bullying in schools: An international perspective (pp. 9–33). New York: Routledge. Palframan, D. (1994). Expert deplores emotional abuse in sport. Coaches Report, 1(2), 3–5. Pellegrini, A. & Long, J. (2002). A longitudinal study of bullying, dominance and victimisation during the transition from primary school through secondary school. British Journal of Developmental Psychology, 20, 259–280. Renfrew, C. (2017). Introduction: Play as the precursor of ritual in early human societies. In Renfrew, C., Morley, I. & Boyd, M. (Eds.), Ritual, play and belief in evolution and early human societies (pp. 9–19). Cambridge: Cambridge University Press. Rivers, I. (2010). Bullying, homophobia and transphobia in sport: At what cost discrimination? In Brackenridge, C. H. & Rhind, D. (Eds.), Elite child athlete welfare: International perspectives (pp. 80–84). Uxbridge: Brunel University Press. Salmivalli, C. (2010). Bullying and the peer group: A  review. Aggression and Violent Behaviour, 15(2), 112–120. Smith, P. K. (2014). Understanding school bullying: Its nature and prevention strategies. London: Sage. Stirling, A. E. (2013). Understanding the use of emotionally abusive coaching practices. International Journal of Sports Science and Coaching, 8(4), 625–639. Stirling, A. E., Bridges, E., Cruz, L. & Mountjoy, M. (2011). Canadian academy of sport and exercise medicine position paper: Abuse, harassment and bullying in sport. Clinical Journal of Sport Medicine, 21, 385–391. Stirling, A. E. & Kerr, G. (2008). Defining and categorising emotional abuse in sport. European Journal of Sport Science, 8(4), 173–181. Stirling, A. E. & Kerr, G. (2009). Abused athletes’ perceptions of coach-­athlete relationship. Sport in Society, 12(2), 227–239. Twemlow, S., Biggs, B., Nelson, T., Vernberg, E., Fonagy, P. & Twemlow, S. (2008). Effects of participation in a martial arts-­based anti-­bullying programme in elementary schools. Psychology in Schools, 45(10), 947–959. 117

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Ventura, C., Prat, M., Ríos, X., Flores, G., Lleixà, T. & Soler, S. (2019). Bullying i ciberbullying al futbol formatiu a Catalunya. Barcelona: Fundació Barça. Volk, A. & Lagzdins, L. (2009). Bullying and victimisation among adolescent girl athletes. Athletic Insight, 1(1), 15–25. World Health Organisation and the International Society for the Prevention of Child Abuse and Neglect (2006). Preventing child maltreatment: A  guide to taking action and generating evidence. Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/43499/9241594365_eng.pdf?sequence=1

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10 Degrading and harming new teammates during hazing ‘Athletes will be athletes’ Jennifer J. Waldron

Introduction Sport is a popular activity for youth around the world. Although it is accurate that sport can create productive, civic behaviours, it is also accurate that the structure and environment of sport may encourage violence among and against athletes, as many of the chapters in this compilation attest. This interpersonal violence has received the most attention in the scientific community (Parent & Fortier, 2018). Of interest to this chapter is interpersonal violence (i.e. verbal, emotional, physical, or sexual) that occurs because of peer-­to-­peer behaviours. Interpersonal violence may occur through initiation ceremonies that occur in sport. In the United States and Canada, initiation ceremonies are often termed ‘hazing’. Regardless of the term, similar phenomena exist across the world, including ‘bizutage’ in France, ‘mopokaste’ in Finland, ‘novatada’ in Spain, ‘ragging’ in India, and ‘praxe’ in Portugal (Dias & Sá, 2014). Although this chapter focuses on hazing, it is important to differentiate hazing from bullying. Usually bullying happens to members of an ‘out’ group who will never become accepted members of the ‘in’ group in spite of the repeated, continual bullying (Tofler, 2016). In contrast, hazing happens to rookies (i.e. new members) by veterans (i.e. older members) for the rookies to gain full acceptance onto a team (Cimino, 2011; Waldron & Kowalski, 2009). The hazing experiences typically occur in the beginning of the athletic season and then cease. The purpose of this chapter is to explore hazing as an experience that negatively impacts the welfare of athletes. First, the chapter explores rates of hazing as well as resultant harm. Second, the chapter integrates risk factors of hazing to the levels of the ecological model of violence (Krug, Mercy, Dahlberg & Zwi, 2002). Parent and Fortier (2018) adapted these ecological levels to represent individual, relational, organisational, and sociocultural factors. By understanding these factors, practitioners can better understand how peer-­to-­peer violence, in the form of hazing, occurs in sport. It should be noted that most of the research conducted about hazing has been with college athletes rather than youth athletes. Because the sport milieu is so strong, it is expected that similar hazing mechanisms exist for youth athletes and, therefore, are pertinent to their experiences. Additionally, most of the work has been conducted with athletes in Western European countries, particularly the United States. Hence, it will be noted when the sample of athletes is from a country other than the United States. 119

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Hazing rates and harm With almost daily reports in newspapers, it seems that hazing is a common practice in sport. However, capturing the true extent of hazing is complicated, and it is likely underreported in research. First, hazing is illegal in most places in the United States, so athletes may be hesitant to share their engagement in these behaviours. Second, many athletes do not consider their behaviours to be acts of hazing and thus may not state they have been hazed. Researchers report a disconnection between self-­identification of hazing experiences and engaging in experiences that are considered hazing based on the definition (Allan, Kerschner & Payne, 2019; Hamilton, Scott, LaChapelle & O’Sullivan, 2016; Johnson, Guerrero, Holman, Chin & Signer-­Kroeker, 2018). For example, 90% of college students and 40% of Canadian athletes who experienced hazing behaviours did not consider themselves to have been hazed (Allan & Madden, 2013; Johnson et al., 2018). Most researchers, then, report the percentage of athletes who engaged in at least one hazing behaviour rather than asking if athletes have experienced hazing. College athlete samples from the United Kingdom, Canada, and United States showed that between 42% and 74% reported engaging in at least one hazing behaviour (Allan & Madden, 2013; Allan et al., 2019; Hamilton et al., 2016; Johnson et al., 2018). Although few have been published, studies have shown between 17% and 24% of athletes in secondary school experienced at least one hazing behaviour (Gershel, Katz-­Sidlow Small & Zandieh, 2003; Hoover & Pollard, 2000). Waldron (2015) reported that 27% of high-­school athletes experienced mild hazing (e.g. being cursed at or having food thrown at you), and 31% experienced severe hazing (e.g. being hit, being kicked, or engaging in sexual acts). Similar to collegiate athletes, youth athletes likely underreport their hazing behaviours for various reasons (Gershel et al., 2003). Taken together, the data show that hazing is occurring at all age and competitive levels of sport, at least in Western European nations. The most common definition of hazing is “any activity expected of someone joining a group that humiliates, degrades, abuses, or endangers regardless of person’s willingness to participate” (Hoover, 1999, p.  8). This definition acknowledges a spectrum of hazing behaviours, from harmless fun to violence (Waldron, 2014). When hazing is considered harmless fun, it is often thought of as a team tradition or initiation that simply embarrasses athletes. At this end of the spectrum, hazing can be dismissed because it is simply ‘athletes being athletes’ and there is no visible harm. Hazing as ‘harmless fun’ leads to athletes condoning hazing as long as no one is visibly hurt or injured (Waldron, 2014; Waldron  & Kowalski, 2009). These more questionable types of hazing activities include being cursed at, being required to wear embarrassing clothing, acting as a servant, and consuming disgusting food combinations (Allan & Madden, 2013). However, research has found that hazing as ‘harmless fun’ can still embarrass and degrade rookies (Gershel et al., 2003), as well as causing social distancing among members (Waldron & Kowalski, 2009). This psychological and emotional harm can live with athletes for a long time and impact the well-­being of athletes in ways that are not obvious to coaches or parents. Before discussing violent hazing, it is necessary to consider the role of alcohol in hazing behaviours, especially when the hazing occurs outside of practice and competition. Data show approximately 55% of college athletes reported participation in drinking games as part of their hazing (Allan & Madden, 2013; Hamilton et al., 2016). By forcing consumption of alcohol, rookies can loosen up, relax, and be more willing to participate in hazing. Similarly, alcohol reduces the inhibition of veterans to increase their inclination to harm teammates through hazing. Alcohol use, particularly drinking games or binge drinking, often results in physical harm to rookies, including passing out or blacking out. Additionally, alcohol may loosen inhibitions 120

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to the point where the hazing crosses a line and becomes dangerous and harmful to the rookies. Alcohol use during hazing experiences tends to happen with college-­aged athletes and is less likely to accompany the hazing behaviours of youth athletes. In a sample of middle-­school and high-­school athletes, only 2% reported alcohol use in their hazing experiences (Gershel et al., 2003). This may be due to youth athletes having less access to alcohol and an inability to gather outside of practice or competition. At the other end of the spectrum is hazing as peer-­to-­peer violence. These hazing acts are so violent that they often end up in the news. Examining news articles about hazing, Mathers and Chavez (2018) showed that 21 of the 30 stories identified contained more than one type of violence. Violent hazing behaviours can include being paddled or beaten, being kidnapped without proper clothing and made to find their way home, consuming exorbitant amounts of liquids, or being sexually assaulted. Portuguese athletes reported experiencing both physical (6.8%), and sexual (47.1%) hazing (Fávero, Pinto, Ferreira, Machado  & Del Campo, 2018). Waldron (2014) discussed that when hazing is perceived as sufficiently violent, we often switch our language from ‘veterans’ and ‘rookies’ to ‘perpetrators’ and ‘victims’ to denote the criminality of the acts. Unfortunately, all hazing has violence embedded in the act, and when we use the language of ‘initiation’ or ‘hazing’, the focus on this violence is decreased (Massey & Massey, 2017). It is also common for hazing acts that may be less violent to easily escalate to physical or sexual violence, especially when alcohol is present. Understanding rates and types of hazing as well as resulting harm are important. However, it is also critical to understand why hazing happens.

The ecological model of violence Hazing, similar to other forms of interpersonal violence, is a complex phenomenon. There are many factors interacting together that may place certain athletes at higher or lower risk of experiencing hazing. The ecological model of violence (Krug et al., 2002) is useful in grouping similar variables together. This section draws on conceptual explanations and empirical data to support why hazing occurs in group environments like sport (Cimino, 2011; Waldron, 2014; Waldron  & Krane, 2005). These include hazing for 1) showing commitment to one’s team, 2) increasing team cohesion, and 3) expressing power over rookie members (Van Raalte, Cornelius, Linder & Brewer, 2007; Waldron & Krane, 2005). Although these conceptual explanations provide insight into hazing experiences, they are not theories to empirically test, and they tend to oversimplify hazing (Waldron, 2016). Both qualitative and quantitative research has been used to support these conceptual explanations; however, the explanations cannot be fully tested, making it difficult to truly understand hazing. This section, then, groups commonly examined hazing variables within the ecological model.

Sociocultural factors According to Parent and Fortier (2018), a critical sociocultural factor that heightens the risk of interpersonal violence is the normalisation and tolerance of violence in sport. Indeed, sport is an environment where athletes are expected to adhere to the power and performance model. In this model of sport, success is measured by winning and being the best, leading athletes to do whatever it takes to achieve these accolades (Coakley, 2017). Athletes, through socialisation, learn to adhere to the norms of playing through pain and making sacrifices for the game in order to gain status and respect (Hughes & Coakley, 1991). Although sport has traditionally been a masculine-­defined domain, Waldron and Krane (2005) have argued that female athletes 121

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are increasingly adopting the power and performance model of sport because the rewards are so great. It is likely that this sociocultural milieu of sport decreases the welfare of athletes due to the pressure to win at all costs. Within the performance and power model of sport, athletes often view their bodies as a machine or a weapon. This view leads athletes to engage in aggression and violence in order to be triumphant (Coakley, 2017). Hazing, then, becomes normalised peer-­to-­peer violence on an athletic team and a way to prove commitment to the team (Waldron, 2016). Veteran members are willing to exert violence on their teammates because the subculture of sport encourages it. Moreover, veteran members need to ensure their teammates will remain dedicated to the team during intense and extreme competition (Waldron, 2016; Waldron & Kowalski, 2009). Veteran members view hazing as a test of whether rookies are able to withstand violence or pain to the body. If rookies are able to sustain the pain, then they successfully demonstrate their commitment to the team and become fully accepted members. For rookies, viewing the body as a machine means they are expected to endure and disregard the pain associated with hazing. Waldron (2014) argued that when rookies do not show pain to veteran members, veteran members have license to impart more pain on the rookies. Also, rookies may be willing to take on more pain in order to prove their commitment to the team. This mentality may lead to greater levels of hazing and result in more severe injury and harm. Beyond the physical harm, the expectation to sustain the pain and carry the secret of hazing will cause decreases in the athlete’s psychological and emotional health.

Organisational factors Within the power and performance model of sport that exists, organisational factors of a league or a sport team often contribute to hazing behaviours (Parent & Fortier, 2018). Factors that may increase hazing on a team are a lack of enforcement of rules regarding hazing, coaches creating a performance climate, and low levels of supervision by coaches. Although athletes are the instigators of hazing, coaches may encourage or discourage hazing based on their involvement and their enforcement of policies. Quantitative work with college athletes from the United States and Canada found that 33% and 40% of athletes, respectively, reported their coach had some knowledge about hazing occurrences, and 25% and 33% reported their coaches were present during the hazing (Allan et al., 2019; Johnson et al., 2018). Similarly, interviewed athletes shared that they perceived their coaches ignored the hazing and allowed the hazing to happen, especially if the coach believed the hazing was under control or would not become too harmful (Kowalski & Waldron, 2010; Waldron, Lynn & Krane, 2011). Although far fewer in number, some interviewed athletes did perceive their coaches to take a proactive stance against hazing, and other athletes reported that their coach actively encouraged veterans to haze their teammates (Kowalski & Waldron, 2010). Research has also explored the role of coaches in transmitting hazing policy from athletic administrators to the players (Johnson  & Donnelly, 2004). Interviewed Canadian coaches reported a range of responses to this role. Some coaches transmitted the hazing policy to athletes but then did not actively oppose hazing if it did not cross the line and harm athletes. Other coaches worked to create more welcoming traditions to replace hazing (Johnson & Donnelly, 2004). Quantitative data showed that 57% of Canadian athletes reported that their coach clearly stated expectations prohibiting hazing, yet the athletes were not provided information about positive and productive team-­building activities (Johnson et al., 2018). These results suggest that coaches often actively encourage or turn a blind eye to hazing on their team. When this happens, it is likely that athletes are more likely to experience hazing and resulting harm. 122

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Those coaches who encourage hazing on their team, theoretically, are probably creating a performance-­motivational climate. Here, coaches focus on rivalry among teammates, unequal treatment of players, and punishment, thus creating an environment ripe for hazing. In this climate, athletes are often willing to do whatever it takes to receive the recognition of being a winner (Waldron & Krane, 2005). Using a systematic review, Harwood and colleagues (2015) showed a moderate positive relationship between perceptions of a performance climate and antisocial behaviours (i.e. intimidation or attempts to injure others). Other research suggests that adolescent athletes with less relational support from coaches displayed greater antisocial behaviours (Rutten et al., 2011). Considering that hazing is a type of antisocial behaviour, it is likely that engagement in hazing increases when an athlete participates in a performance climate with less social support from coaches. Although little data exist, popular press stories suggest that much hazing occurs when coach or parental supervision is lacking. Many Canadian college athletes and college athletes from the United States reported that hazing typically occurred on a weekend night off-­campus (Allan et al., 2019; Johnson et al., 2018). On the other hand, hazing of youth athletes often occurred in the locker room, the weight room, or on the bus when their coaches were not supervising (Waldron et al., 2011). Indeed, Weddle (2004) argues that schools have a duty to properly supervise their athletes to protect them from hazing. The environment and the supervision structures set up by coaches create situations that, intentionally or not, condone hazing on the team. These organisational factors influence how teammates interact with each other.

Relational factors Relationships among athletes also influence the likelihood of hazing on a sport team. In particular, research has focused on how imbalances of power between veterans and rookies leads to increased risk of violence and victimisation (Parent & Fortier, 2018). One conceptual explanation for hazing that emerges from relational factors is the power imbalance where the veterans dominate the rookies (Waldron & Kowalski, 2009). While new athletes desire acceptance and full approval on the team, veteran members want to show that they are superior, have certain privileges, and can exert power (Waldron et al., 2011). Another conceptual explanation for hazing is that by being hazed, athletes can exhibit their commitment to the team. Here, the need to show commitment to the team is enhanced because of the power and performance model of sport. Many athletes, then, endure hazing even if they do not want to. By surviving hazing, rookies learn to conform to the values of the team and become fully accepted members of the team and to understand the team hierarchy (Waldron & Kowalski, 2009). From this theoretical work, empirical studies have examined team cohesion. Linked to the team power structure is the spurious notion that hazing increases team cohesion (Allan & Madden, 2008; Waldron & Kowalski, 2009; Waldron et al., 2011). Athletes who endure the pain, abuse, and degradation of hazing are then socialised to be loyal and devoted to their teammates (Pershing, 2006). Reflecting on their high-­school experiences, college male athletes shared narratives of the hazing experience, including that hazing made them friends. For example, one commented: I know I felt more a part of the team after being hazed . . . everybody was so close and family-­oriented . . . you could trust them. (Waldron et al., 2011, p. 117) A woman, reflecting on being hazed as a high-­school athlete, stated, “I’ll fit in and they’ll like me” (Waldron & Kowalski, 2009, p. 298). Similarly, female athletes in the United Kingdom 123

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reported that being hazed allowed them to feel more accepted by other team members (Lafferty & Wakefield, 2018), and 63% of Canadian athletes reported that they felt like they belonged to the team more as a result of being hazed (Johnson et al., 2018). Yet there is evidence rebuking the claim that hazing results in improved team cohesion. For example, hazing was found to deter the development of team cohesion on college teams in the United States (Van Raalte et al., 2007), and no relationship was found between hazing and cohesion in college athletes from the United Kingdom (Lafferty, Wakefield & Brown, 2017). Interviews with athletes revealed that hazing caused separation between veterans and rookies, which was detrimental to the performance of the team (Waldron & Kowalski, 2009). Moreover, female athletes in the United Kingdom shared that hazing had a lasting negative impact on athletes and their relationships with teammates (Lafferty & Wakefield, 2018). Forgoing hazing may lead to a lack of respect by teammates, negatively influencing team cohesion (Waldron et al., 2011). Indeed, hazing often results in the illusion of team bonding, but the bonding is based on fear. Even if athletes believe the illusion that hazing builds cohesion, the resulting severe psychological and/or physical consequences of hazing harm the welfare of athletes and negate the supposed team building. Beyond creating team cohesion, many athletes engage in hazing to conform to the group norms and show loyalty to the team. These justifications often lead athletes to willingly participate in the hazing and to downplay the danger of the hazing behaviours (Waldron & Kowalski, 2009). Moreover, the power dynamic also leads to athletes remaining quiet about the hazing for fear of losing the acceptance of their teammates or fear of retaliation (Allan  & Madden, 2008; Waldron, 2014; Waldron et al., 2011; Waldron & Kowalski, 2009). Even when athletes are harmed or injured, many remain quiet about their experiences. But keeping the hazing a secret often leads to more distress and emotional harm. These relational factors, then, have a significant impact on the welfare of athletes.

Individual factors The individual level of the ecological model includes demographic characteristics and dispositional characteristics (Krug et al., 2002; Parent & Fortier, 2018). Regarding hazing, research has posited that competitive level, past hazing experiences, and gender may be individual risk factors for hazing. Competitive level is positively related to hazing behaviours. There have been a number of reports that collegiate athletes were more likely to experience hazing episodes than high-­school athletes (Hoover, 1999; Hoover & Pollard, 2000; Waldron, 2015). It is possible that those at higher levels of competition perceive a greater need for new members to demonstrate their commitment to the team. Yet it is concerning that youth are engaging in hazing behaviours given that one of the most significant risk factors for hazing is prior hazing. For example, 79% of collegiate athletes reported being hazed as a high-­school athlete (Hoover, 1999). Meanwhile, Canadian and Portuguese athletes who were hazed as rookies ended up hazing other rookies when they became veterans (Fávero et al., 2018; Hamilton et al., 2016). Athletes have also reported that veterans who were hazed looked forward to hazing rookies (Johnson et al., 2018; Waldron & Kowalski, 2009). Because hazing emerges from military settings, and both the military and organised athletics traditionally have been male-­defined and male-­dominated institutions, it follows that there is a strong belief that boys engage in hazing more than girls (Pershing, 2006). For example, in a retrospective survey of adults from Belgium and the Netherlands who played childhood sports, researchers clustered together the common profiles of those who perpetrated violence in youth sport (Vertommen et al., 2017). It appears that the common profile is male peer athletes who 124

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work together on the team to enact the violence. Similarly, male athletes in the United Kingdom reported engaging in more hazing activities than female athletes (Lafferty et al., 2017), yet men and women engaged in similar levels of appropriate team-­building activities. Male college students experienced significantly more hazing when joining all organisations (i.e. athletics, bands, fraternities) than women (Allan et al., 2019). Similarly, most news articles report hazing stories from male sports (Mathers & Chavez, 2018). Yet there are also data suggesting that female and male athletes engage in hazing at similar levels. As women continue to adopt the power and performance model of sport, it is likely that they will also engage in hazing behaviours at similar levels to men (Waldron & Krane, 2005). Among students involved in various organisations on college campuses, Allan and Madden (2013) found that women engaged in hazing at similar rates as men. Similarly, there was no difference in mild or severe hazing behaviours between male and female athletes who participated in high school (Gershel et al., 2003; Waldron, 2015) or among college athletes from the United Kingdom or United States (Hamilton et al., 2016; Waldron, 2015). Interestingly, female athletes from Canada reported experiencing more hazing behaviours than their male counterparts (Johnson et al., 2018). These data support the argument that more women are adopting the performance and power model of sport and thus are increasing the likelihood of mental and physical health-­compromising behaviours, including hazing (Waldron & Krane, 2005).

Implications for athlete welfare The welfare of athletes should always be at the forefront of parents’, coaches’, and officials’ attention. What is interesting about hazing is that athlete’s welfare is put at risk by teammates. Indeed, hazing is a type of peer-­to-­peer violence through degrading, humiliating, endangering, or abusing teammates. Although athletes are often physically harmed by hazing, displaying pain or injury is in direct contradiction to what it means to be a tough athlete. Unless the hazing experience results in severe physical or sexual harm, it is likely that athletes will not share or report the damage. It is difficult to fully capture the extent that an athlete’s welfare suffers from hazing. Qualitative research shows that athletes experience significant psychological, emotional, physical, and sexual harm due to hazing (Lafferty & Wakefield, 2018; Waldron & Kowalski, 2009; Waldron et al., 2011). It is critical, then, to work to reduce hazing on athletic teams and create environments where the athlete does not have to suffer harm. The ecological model of violence (Krug et al., 2002) is a framework to meaningfully organise variables that may increase the risk of hazing. It is also useful to consider the various levels – sociocultural, organisational, relational, and individual – and to identify where to prioritise prevention efforts. For example, spending resources to change the power and performance model of sport is probably not efficient. These factors are too distal to the individual and too enormous to change quickly. Additionally, it is impossible to change the individual factors relating to athletes; a coach cannot change whether an athlete has prior hazing experience. Therefore, it may be best to implement hazing-­prevention efforts at the organisational or relational level. At the organisational level, coaches and athletic directors need to have hazing policies that are both communicated to athletes and enforced. Involving senior leaders in this process can help commit the team to preventing hazing. A greater number of athletic organisations should have specific guidelines for supervision of youth athletes. Because many youth athletes experience hazing in the locker room, in the weight room, or on the bus (Weddle, 2004), it is critical that proper observation occur in these and other spaces. Finally, coaches should refrain from creating a performance climate that may lead to antisocial behaviours, such as peer-­to-­peer 125

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violence of their athletes. By focusing on learning and improvement, coaches can create team relationships based on kindness and care rather than rivalry and jealousy. At the relational level, it is important for team leaders to have conversations about hazing, team cohesion, and group norms on their team. Because hazing is often not discussed, there is the erroneous belief that teammates approve of hazing; however, most team members do not approve of hazing because of the harm it causes (Allan, Payne & Kerschner, 2015). Waldron (2012) suggested a five-­step process the can help veteran athletes guide discussion about hazing. The discussion would start with noticing an event as hazing. The second and third steps are to interpret the hazing behaviours as a problem and then to help athletes realise they are responsible for a solution. Finally, the discussion should help athletes acquire skills to speak out against the hazing and then, ultimately, empower athletes to intervene if hazing does occur (Waldron, 2012). In addition to these conversations, team leaders, with the help of coaches, also need to establish team activities that establish group bonding. For example, using cooperative, team-­building, and adventure-­based activities may be a promising way to develop more positive team norms (Johnson & Chin, 2016). By changing team norms, athletes and coaches will create positive team expectations that will enhance the welfare of all athletes.

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Johnson, J.  & Chin, J. W. (2016). Hazing rites/rights: Using outdoor-­and adventure education-­based orientation to effect positive change for first-­year athletes. Journal of Adventure Education and Outdoor Learning, 16(1), 16–30. Johnson, J. & Donnelly, P. (2004). In their own words: Athletic administrators, coaches, and athletes at two universities discuss hazing policies. In Johnson, J. & Holman, M. (Eds.), Making the team: Inside the world of sport initiations and hazing (pp. 155–175). Toronto: Canadian Scholars’ Press. Johnson, J., Guerrero, M. D., Holman, M., Chin, J. W. & Signer-­Kroeker, M. A. (2018). An examination of hazing in Canadian intercollegiate sports. Journal of Clinical Sport Psychology, 12, 1–27. Kowalski, C. & Waldron, J. J. (2010). Looking the other way: Athletes’ perceptions of coaches’ responses to hazing. International Journal of Sports Science and Coaching, 5(1), 87–100. Krug, E. G., Mercy, J. A., Dahlberg, L. L. & Zwi, A. B. (2002). The world report on violence and health. The Lancet, 360(9339), 1083–1088. Lafferty, M. E. & Wakefield, C. (2018). Becoming part of the team: Female student athletes’ engagement in initiation activities. The Sport Psychologist, 32, 125–135. Lafferty, M. E., Wakefield, C. & Brown, H. (2017). “We do it for the team”: Student-­athletes’ initiation practices and their impact on group cohesion. International Journal of Sport and Exercise Psychology, 15(4), 438–446. Massey, K. D. & Massey, J. (2017). It happens, just not to me: Hazing on a Canadian university campus. Journal of College and Character, 18(1), 46–63. Mathers, S. & Chavez, J. (2018). When hazing is not hazing – Media portrayal of hazing: Developing a typology. Introducing the TAIR model. Social Sciences, 7(9), 158–170. Parent, S. & Fortier, K. (2018). Comprehensive overview of the problem of violence against athletes in sport. Journal of Sport and Social Issues, 42(4), 227–246. Pershing, J. L. (2006). Men and women’s experiences with hazing in a male-­dominated elite military institution. Men and Masculinities, 8(4), 470–492. Rutten, E. A., Schuengel, C., Dirks, E., Stams, G. J., Biesta, G. J. & Hoeksma, J. B. (2011). Predictors of antisocial and prosocial behaviour in an adolescent sports context. Social Development, 20(2), 294–315. Tofler, I. R. (2016). Bullying, hazing, and workplace harassment: The nexus in professional sports as exemplified by the first NFL Wells report. International Review of Psychiatry, 28(6), 623–628. Van Raalte, J. L., Cornelius, A. E., Linder, D. E. & Brewer, B. W. (2007). The relationship between hazing and team cohesion. Journal of Sport Behaviour, 30(4), 491–507. Vertommen, T., Kampen, J., Schipper-­van Veldhoven, N., Wouters, K., Uzieblo, K. & Van Den Eede, F. (2017). Profiling perpetrators of interpersonal violence against children in sport based on a victim survey. Child Abuse and Neglect, 63, 172–182. Waldron, J. J. (2012). A social norms approach to hazing prevention workshops. Journal of Sport Psychology in Action, 3(1), 12–20. Waldron, J. J. (2014). A post-­structuralist approach to hazing in sport. In McGannon, K. & Schinke, R. (Eds.), The psychology of sub-­culture in sport and physical activity: A critical approach (pp. 31–47). New York: Psychology Press. Waldron, J. J. (2015). Predictors of mild hazing, severe hazing, and positive initiation rituals in sport. International Journal of Sports Science and Coaching, 10(6), 1089–1101. Waldron, J. J. (2016). Hazing in sport. In Schinke, R., McGannon, K. & Smith, B. (Eds.), International handbook in sport psychology (pp. 304–312). New York: Routledge. Waldron, J. J. & Kowalski, C. L. (2009). Crossing the line: Rites of passage, team aspects, and ambiguity of hazing. Research Quarterly for Exercise and Sport, 80(2), 291–302. Waldron, J. J.  & Krane, V. (2005). Whatever it takes: Health-­compromising behaviours in female athletes. Quest, 57(3), 315–329. Waldron, J. J., Lynn, Q. & Krane, V. (2011). Duct tape, icy hot and paddles: Narratives of initiation onto US male sport teams. Sport, Education and Society, 16(1), 111–125. Weddle, D. (2004). Dangerous games: Student hazing and negligent supervision. Education Law Reporter, 187, 373–384.

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11 Exploring the links between self-­directed violence and child maltreatment and bullying in sport Sylvie Parent, Judith Kotiuga, Tine Vertommen and Kristine Fortier

Introduction Research on the links between child maltreatment in sport and physical and mental health problems in athletes is in its early stages (Mountjoy et al., 2016) and is often characterised by qualitative research designs (e.g. Stirling & Kerr, 2013). Yet it is recognised that trauma from child maltreatment and bullying may lead to multiple negative impacts on a person’s life, such as physical, psychological, behavioural, and social problems (Milot, Collin-­Vézina & Godbout, 2018). The limited data that we have address only some aspects of the possible consequences of this form of violence towards athletes. For example, the recent work of Vertommen, Kampen, Schipper-­van Veldhoven, Uzieblo and van den Eede (2018) showed that severe interpersonal violence against athletes was associated with increased somatisation (e.g. physical symptoms of psychological problems), depression and anxiety, and lower quality of life in adulthood. This association was stronger where athletes suffered from multivictimisation (e.g. victimisation involving more than one type of interpersonal violence). In their ‘Study of the Experiences of Quebec Young Athletes (SEQYA)’, Parent et al. (2018) also found that sexual violence was significantly associated with lower self-­esteem, more psychological distress, and higher likelihood of post-­traumatic stress symptoms in young athletes aged 14 to 17 years old. They found no differences between boys and girls for these factors. Despite this very recent progress in this field, some of the consequences on the lives of victims of child maltreatment and bullying in sport remain understudied, such as self-­directed violence; for example, current research does not address links between child maltreatment, bullying, and manifestations of self-­directed violence (such as self-­harm, disordered eating, and suicide), except in some qualitative studies (Brackenridge, 2001; Fasting, Brackenridge & Walseth, 2002). We have seen an unprecedented increase in research activity aimed at understanding the links between these problems in the general literature; however, most studies have focused on sexual types of child maltreatment, and few studies have focused on such relationships within the sport environment. The aim of this chapter is thus to describe the extent of knowledge of the link between child maltreatment and bullying suffered within the sport environment and 128

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self-­directed violence in athletes. The chapter attempts to address some of these issues and has the following objectives: 1) to give an overview of these links in light of literature inside and outside sport, 2) to suggest that some forms of athletic behaviours could be considered self-­ directed violence and could be linked with child maltreatment from authority figures in sport, and 3) to reflect on the complexity and overlaps between these behaviours. In this chapter, child maltreatment is defined based on the World Health Organisation (WHO) definition (Krug, Dahlberg, Mercy, Zwi & Lozano, 2002, p. 59): All forms of physical and/or emotional abuse, sexual abuse, neglect or negligent treatment, or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity, in the context of a relationship of responsibility, trust or power. Child maltreatment includes sexual, physical, and psychological abuse and neglect (Fortier, Parent  & Lessard, 2020; Krug et  al., 2002). Bullying is defined as an intentional and repetitive aggressive behaviour with an imbalance of power (Olweus, 2010). It can take the form of direct physical or verbal behaviours or indirect behaviours where the ‘victim’ is not present (e.g. online, rumours, purposeful damage to sport equipment) (Parent & D’Amours, 2019). Self-­ directed violence will be defined subsequently.

Self-­directed violence and links with trauma in and outside sport As mentioned previously, child maltreatment and bullying may engender low self-­esteem, self-­ criticism, shame, and self-­hatred (Spinazzola et al., 2017; Turner, Shattuck, Finkelhor & Hamby, 2017). Other symptoms include, but are not limited to, standard post-­traumatic stress disorder (PTSD) symptoms, a pervasive sense of fear and aggression, somatisation, hyperactivity, and learning difficulties (Gabowitz, Zucker & Cook, 2008). Moreover, such experiences have been associated with an increased risk of engaging in self-­directed violence (Gabowitz et al., 2008). Self-­directed violence involves “violence in which the perpetrator and the victim are the same individual and is subdivided into self-­abuse and suicide” (WHO, 2019). Acts of self-­directed violence “are usually aimed at reducing distress or internal pressure or regaining control over one’s life, or arise from poorly adapted hypersensitivity, altered information processing and low impulse control” (Godbout, Girard, Milot, Collin-­Vézina & Hébert, 2018, p. 73). Although self-­directed violence pertains to a specific array of behaviours, including non-­suicidal self-­injury (e.g. self-­harm), disordered eating, and alcohol and drug abuse, most of these behaviours share common traits and functions, such as temporarily regulating emotions or managing coping with pervasive numbness or emptiness. Many experts have established and documented theories in which emotion regulation is key to understanding trauma-­induced symptoms, such as self-­directed violence (e.g. Van der Kolk, Roth, Pelcovitz, Sunday & Spinazzola, 2005). Indeed, it is hypothesised that emotion dysregulation is linked to a number of manifestations of self-­directed violence, such as non-­suicidal self-­injury (self-­harm), disordered eating, and substance abuse (Yates, Carlson & Egeland, 2008). Trauma is associated with engaging in self-­directed violence in adolescence (Gabowitz et al., 2008). Self-­directed violence can be used as a way to adapt to affective and interpersonal demands when one’s developmental trajectory has been coloured by interpersonal trauma. For example, authors have argued that self-­harm can be understood as a deviation from the regular developmental trajectory of self-­organisation. All types of child maltreatment may have deleterious effects on a child’s development and well-­being. Recent reviews show links between child 129

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maltreatment and 1) self-­injury (Lang & Sharma-­Patel, 2011; Serafini et al., 2017), 2) disordered eating (Collin-­Vézina & Hébert, 2012; Kimber et al., 2017), 3) suicide (Xiang Ng, Zheng Jie Yong, Yin Xian Ho, Yutong Lim & Yeo, 2018; Zatti et al., 2017), and 4) addictive behaviours (Konkolÿ Thege et al., 2017). In addition, there is evidence that bullying is linked to self-­harm, suicide attempts, and substance abuse (Thomas et al., 2017) (see the chapter from Nery and colleagues in this collection for more on bullying in youth sport). The next sections present the links between self-­directed violence and child maltreatment (e.g. adult–child relations) but also between self-­directed violence and bullying (e.g. peer-­to-­peer relations).

Child maltreatment and self-­harm Frequent manifestations of self-­harm (also referred to as non-­suicidal self-­injury or NSSI) include inflicting burns, pulling skin or hair, severe scratching, and self-­bruising (Lang & Sharma-­Patel, 2011). In a recent paper, Parent and Fortier (2018a) suggested that the use of sport equipment by athletes to punish themselves for a bad performance or the wrong attitude in sport could also constitute a form of self-­harm (e.g. hitting themselves with a helmet or a tennis racket). Child maltreatment is an important risk factor for self-­harm (Isohookana, Riala, Hakko  & Räsänen, 2013; Shenk, Noll & Cassarly, 2010). The forms of child maltreatment that are the most studied in relation to self-­harm are sexual and physical abuse. Moreover, chronic abuse, as opposed to isolated episodes of maltreatment, increases the risk of self-­harm in both males and females (Guvendeger et al., 2017). In terms of gender differences, studies have shown that when sexual abuse occurs, females are more likely to exhibit self-­harm behaviours (Isohookana et al., 2013; Swannell et al., 2012). However, this difference is erased when sexual and physical abuse co-­occur (Gibb & Alloy, 2006). Various mediating factors have also been identified as playing a part in the relationship between child maltreatment and self-­harm. These include, but are not limited to, negative perceptions of the self (Weismoore & Esposito-­Smythers, 2010), dissociation and alexithymia1 (Swannell et al., 2012), low self-­esteem, psychopathology, body dissatisfaction (Muehlenkamp, Claes, Smits, Peat & Vandereycken, 2011), and post-­traumatic stress symptoms (Shenk et al., 2010). In the sport context, self-­harm has not received much attention from researchers. Findings from the Experiences of Children Participating in Organised Sport in the UK study show that out of 6,000 participants, 10% said they had self-­harmed. Of these, 56% reported hitting and punching themselves, 55% had scratched and torn their skin, and 39% reported having cut themselves (Alexander, Stafford & Lewis, 2011). In this study, the likelihood of self-­harming was similar for males and females; however, the types of self-­harm behaviours differed between the sexes, with young men reporting hitting themselves more than women, and young women reporting scratching and cutting themselves more than men. Interviews shed light upon the factors that athletes attributed to their self-­harm. In most cases, negative body and self-­image were the main reasons cited, and some noted that self-­harm provided them with a sense of control over the high-­pressure and performance-­driven situation in which they found themselves.

Child maltreatment and disordered eating A literature review from Collin-­Vézina and Hébert (2012) showed that all experiences of child maltreatment are associated with the development of disordered eating and eating disorders (see Jenny McMahon’s chapter in this collection for more on this topic). Moreover, the accumulation of different types of maltreatment seems to have a greater impact on the development of 130

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these problems than experiences of a single form of maltreatment. In sport, some authors have suggested that problematic weight management techniques in athletes constitute a form of self-­ directed violence (Mountjoy, Rhind, Tiivas & Leglise, 2015; Parent & Fortier, 2018a, 2018b; Young, 2012). The limited evidence available that links child maltreatment in sport, disordered eating/eating disorders, and problematic weight management techniques in athletes shows that sexual violence experienced inside sport is linked to higher rates of eating disorders in athletes (Sundgot-­Borgen, Fasting, Brackenridge, Torstveit & Berglund, 2003). For athletes, the sport environment could increase general risk factors for disordered eating practices and problematic weight management techniques, such as personality and having suffered from interpersonal trauma. Indeed, research suggests that even after controlling for general social pressures surrounding body image, pressures induced by coaches and teammates are associated with more restrained eating and bulimic symptoms (Galli, Petrie, Reel, Chatterton & Baghurst, 2014; Reel, Petrie, SooHoo & Anderson, 2013). Certain body shapes and sizes are assumed to be advantageous for certain sports, and sport-­specific body ideals may lead athletes to develop negative feelings towards their body (Stirling  & Kerr, 2012). Body dissatisfaction may also be increased when an athlete has to wear revealing and form-­fitting attire as part of their sport (Stirling  & Kerr, 2012). Moreover, it is commonly assumed in many sports that weight loss will lead to increased performance (McGannon & McMahon, 2019; Papathomas & Lavallee, 2014). Recently, Fortier et al. (2020) suggested that forcing or asking a child athlete to engage in problematic weight management techniques to achieve the ‘ideal’ weight in their sport constitutes psychological maltreatment. Despite some very interesting qualitative work around problematic weight management techniques and poor coaching practices where manifestations could be associated with maltreatment (see Lang, 2015 and McGannon & McMahon, 2019), more research needs to be done to clarify the impact of child maltreatment in sport and these behaviours.

Child maltreatment and suicide A recent meta-­analysis showed that sexual, physical, and emotional abuse as well as physical neglect as a child are associated with suicidal attempts (Zatti et al., 2017) (see Ashwin L. Rao’s chapter in this compilation for more on athletes and the risk of suicide). The type of child maltreatment experienced is important here; in descending order, physical abuse, emotional abuse, sexual abuse, and physical neglect increase the chance an individual will attempt suicide later in life (Zatti et al., 2017). Meanwhile, another meta-­analysis concluded that child sexual abuse is a significant risk factor for suicide attempts (Xiang Ng et al., 2018) – those who experienced child sexual abuse were nearly twice as likely to attempt suicide compared to those who did not. Qualitative studies also show that some athletes who have experienced sexual abuse in sport have reported having suicidal thoughts (Brackenridge, 1997; Fasting et al., 2002). The work of Alexander and colleagues in 2011 showed that some young athletes had attempted suicide, with 0.8% of the participants surveyed about their experiences in sport reporting having made one or more suicide attempts during their lifetime. However, data that clearly link child maltreatment in sport to suicide, suicide attempts, or suicidal thoughts are, as yet to our knowledge, absent.

Child maltreatment and substance abuse There seems to be an association between child maltreatment and the abuse of substances such as alcohol and drugs (Butt, Chou  & Browne, 2011; Kristman-­Valente  & Wells, 2013; 131

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Tonmyr, Thornton, Draca  & Wekerly, 2010). According to Konkolÿ Thege and colleagues (2017), addictive behaviours include a variety of potentially problematic behaviours such as gambling, excessive sexual behaviour, overwork, and overeating, and these behaviours could be related to victimisation. For example, some studies have found links between child maltreatment and gambling (e.g. Hodgins et al., 2010). In sport, we do not have clear evidence documenting the link between child maltreatment and substance abuse or other addictive behaviours in athletes, although biographies of some athletes who have experienced child maltreatment in sport reveal alcohol and drug misuse and gambling problems (Fleury & McLellan, 2009; Kennedy & Grainger, 2006) (see Carwyn Jones’s chapter in this collection for more on athletes and addiction).

Bullying and self-­directed violence When we look at other forms of interpersonal violence that children experience, bullying is reported as a prevalent problem, especially in schools (Menesini & Salmivalli, 2017). This is a peer-­to-­peer problem. Some studies have looked at links between bullying and self-­directed violence. Thomas et al. (2017) found that bullying was associated with substance misuse, self-­ harm, and attempted suicide in a sample of young Australians. These results are supported by other more recent research (Holt, Vivolo-­Kantor & Polanin, 2015; Lereya et al., 2013; Ttofi, Farrington, Lösel, Crago & Theodorakis, 2016). In sport, one recent study showed that athlete victims of homophobic bullying reported experiencing suicidal thoughts and self-­directed violence such as self-­harm (Symons, O’Sullivan, Borkoles, Anderson & Polman, 2014). Indeed, nearly half of participants who experienced homophobic bullying reported having thought of self-­harm or suicide or both. Of that group, one-­third adopted self-­harm behaviours and 14% attempted suicide. Clearly, more studies need to be conducted to better understand links between bullying in sport and self-­directed violence in young athletes.

Child maltreatment in sport and athletic behaviours considered self-­directed forms of violence We suggest that self-­destructive behaviours in athletes should not be restricted to the previously mentioned behaviours. Indeed, Parent and Fortier (2018a), Young (2012) and Mountjoy et al. (2015) also argue that continuing to train and/or compete despite being injured or ill and engaging in doping could also constitute forms of self-­directed violence. These behaviours could be initiated directly by young athletes themselves, without any influence from others like coaches, parents, or other people in the athlete entourage (Young, 2012). However, there is also plenty of research demonstrating that these behaviours could also be influenced by norms and behaviours of others who are around athletes (Goulet, Valois, Buist  & Côté, 2010; Hughes  & Coakley, 1991; Liston, McDowell, Scott-­Bell & Waddington, 2018; Mayer et al., 2018;). Indeed, some authors document instances of (child) athletes training while injured and engaging in doping and discuss how these were sometimes encouraged or mandated, even rewarded, by authority figures like parents, coaches, or the medical team (e.g. David, 2005; Gravel, 2008; McEwen & Young, 2011; Pesta, 2019; Ryan, 1995). For many authors in sport, these situations constitute child maltreatment (David, 2005; Fortier et al., 2020; Stirling, 2009). Such links have been documented in many sociological studies. However, we believe that more work needs to be done around understanding the impact of child maltreatment by authority figures on the adoption of these behaviours, namely how the exposure to sexual, psychological, and physical maltreatment and neglect in sport could lead to doping and training while injured and ill. 132

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Reflections, future research, and implications for athlete welfare Linking child maltreatment and bullying to self-­directed violence could seems fairly obvious. However, there are some points to consider, especially when we talk about problematic athletic behaviours, such as doping, training/competing while injured or ill, and the use of problematic weight management techniques. Atkinson and Young (2008, p. 110) suggest that self-­directed violence (or self-­aggression) may be defined as “encompassing self-­initiated, intentional, and athletically based practices that directly jeopardise the health and physical, psychological, or emotional well-­being of athletes”. In this definition, the concept of intention is central. However, it has been demonstrated that disordered eating (Coker-­Cranney & Reel, 2015), doping (Duncan, Hallward  & Alexander, 2018; Nicholls et  al., 2017; Ntoumanis, Ng, Barkoukis  & Backhouse, 2014), and training/competing while injured (Pike, 2010) are not always purely intentional and self-­initiated in the sense that athletes also often experience pressure from the sport environment itself and from coaches and sport organisations to conform to these ‘norms’. Normalisation of these behaviours in sport (and also other types of negative behaviours in this context) is well studied from a sociological perspective. However, we think that other disciplines in sport also need to consider normalisation and conformity more when they analyse these problems. Another element that warrants reflection is the complexity of research about child maltreatment and bullying in sport and self-­directed violence in young athletes. From the limited evidence we have, these phenomena seem to be related. For example, when looking at the literature on suicide in athletes, we know that the risk factors are multiple. A review by Baum (2005) shows that injuries, psychosocial stressors, pressure to win, substance abuse (e.g. abuse of performance-­enhancing substances and non–performance-­enhancing substances, such as painkillers), athletic retirement, and psychopathology (e.g. eating disorders) constitute predisposing factors for suicide in athletes. However, for the moment, we cannot clearly link child maltreatment or bullying to suicide ideation or attempts. For disordered eating, Sundgot-­Borgen and Torstveit (2004) identify that injuries, overtraining behaviours, attitudes of coaches (e.g. frequent regulation of weight by coaches), and pressure to lose weight in order to achieve the supposed ‘perfect’ body for sport also constitute predisposing factors. However, a clear picture of the links between child maltreatment (or bullying) and disordered eating is currently lacking. To conclude, the links between child maltreatment and bullying in sport and self-­directed violence are complex and need further analysis. This analysis needs to go further than simply looking at links between the behaviour and sexual abuse in sport. We also need to adopt statistical models and research designs that allow us to better understand predictors and consequences of child maltreatment and bullying and the link with self-­directed violence, as well as possibly influencing factors such as perceived norms and values, personality characteristics, and availability of support in the sport environment. This will certainly help in reaching a more comprehensive understanding of how those behaviours are related/linked to child maltreatment and bullying and why young athletes display such behaviours. Also, it seems to us that interdisciplinary work is required to better understand this phenomenon. Finally, in terms of implications for athlete welfare, it is important to consider the possibility that athlete ‘victims’ of child maltreatment or bullying in sport could be at risk of engaging in self-­directed violence and, equally, that athletes adopting self-­directed violence behaviours could have experienced or could be more at risk of experiencing child maltreatment or bullying in and outside sport. Health professionals are in a good position to question athletes about these issues and offer support and care if needed. Clinical psychologists and other health care professionals apply clinical screening questionnaires and semi-­structured interviews, including questions on 133

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self-­directed violence, when assessing someone’s psychopathology. Sport psychology and medicine professionals might adopt these screening tools to better assess athletes’ vulnerability or exposure to self-­directed violence as well as to other types of violence. Sport organisations, coaches, parents, and local welfare officers in sport are usually not trained in the clinical assessment of an athlete’s well-­being. Awareness raising and education on athlete health are key in order to enhance their capacity to prevent, detect, and refer signs of (self-­directed) violence towards athletes.

Note 1 Dissociation is a heterogeneous phenomenon that involves disconnecting from thoughts or one’s sense of self in the here and now. Alexithymia refers to a general lack of emotional awareness and an impairment in the ability to identify and distinguish feelings.

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Milot, T., Collin-­Vézina, D.  & Godbout, N. (2018). Trauma complexe: Comprendre, évaluer et intervenir. Québec, Canada: University of Québec Press. Mountjoy, M., Brackenridge, C., Arrington, M., Blauwet, C., Carska-­Sheppard, A., Fasting, K., Kirby, S., Leahy, T., Marks, S., Martin, K., Starr, K., Tiivas, A. & Budgett, R. (2016). The IOC Consensus Statement: Harassment and abuse (non-­accidental violence) in sport. British Journal of Sports Medicine, 50, 1019–1029. Mountjoy, M., Rhind, D. J. A., Tiivas, A. & Leglise, M. (2015). Safeguarding the child athlete in sport: A review, a framework and recommendations for the IOC youth athlete development model. British Journal of Sports Medicine, 49, 883–886. Muehlenkamp, J. J., Claes, L., Smits, D., Peat, C. M. & Vandereycken, W. (2011). Non-­suicidal self-­injury in eating disordered patients: A test of a conceptual model. Psychiatry Research, 188, 102–108. Nicholls, A. R., Cope, E., Bailey, R., Koenen, K., Dumon, D., Theodorou, N. C., Chanal, B., Saint Laurent, D., Müller, D., Andrés, M. P., Kristensen, A. H., Thompson, M. A., Baumann, W. & Laurent, J.-­F. (2017). Children’s first experience of taking anabolic-­androgenic steroids can occur before their 10th birthday: A systematic review identifying 9 factors that predicted doping among young people. Frontiers in Psychology, 20(8). doi:10.3389/fpsyg.2017.01015 Ntoumanis, N., Ng, J. Y. Y., Barkoukis, V. & Backhouse, S. H. (2014). Personal and psychosocial predictors of doping use in physical activity settings: A meta-­analysis. Sports Medicine, 44(11), 1603–1624. Olweus, D. (2010). Understanding and researching bullying: Some critical issues. In Jimerson, S., Swearer, S. & Espelage, D. (Eds.), Handbook of bullying in schools: An international perspective (pp. 9–33). New York: Routledge. Papathomas, A. & Lavallee, D. (2014). Self-­starvation and the performance narrative in competitive sport. Psychology of Sport & Exercise, 15, 688–695. Parent, S. & D’Amours, C. (2019). L’intimidation en sport. Trousse medias sur l’intimidation. Institut national de santé publique du Québec (INSPQ). Retrieved from: www.inspq.qc.ca/intimidation/jeunes/ intimidation-­en-­contexte-­sportif Parent, S. & Fortier, K. (2018a). Violence envers les athlètes dans le contexte sportif. In Tiré du Rapport québécois sur la violence et la santé. Institut national de santé publique du Québec (INSPQ). Retrieved from: www.inspq.qc.ca/sites/default/files/publications/2380_chapitre-­8.pdf Parent, S. & Fortier, K. (2018b). Comprehensive overview of the problem of violence against athletes in sport. Journal of Sport and Social Issues, 42(2), 227–246. Parent, S., Vaillancourt-­Morel, M.-­P., Lessard, G., Goulet, C., Demers, G. & Hartill, M. (2018). La violence sexuelle vécue par les jeunes athlètes du Québec en contexte sportif. Paper presented at Colloque sur les violences interpersonnelles, Montréal, Canada, May. Pesta, A. (2019). The girls: An all-­American town, a predatory doctor and the untold story of the gymnasts who brought him down. New York: Seal Press. Pike, E. C. J. (2010). The elite child athlete and injury risk. In Brackenridge, C. & Rhind, D. (Eds.), Elite child athlete welfare: International perspectives (pp. 51–59). Uxbridge: Brunel University Press. Reel, J. J., Petrie, T. A., SooHoo, S. & Anderson, C. M. (2013). Weight pressures in sport: Examining the factor structure and incremental validity of the weight pressures in sport – females. Eating Behaviours, 14(2), 137–144. Ryan, J. (1995). Little girls in pretty boxes: The making and breaking of elite gymnasts and figure skaters. New York: Doubleday. Serafini, G., Canepa, G., Adavastro, G., Nebbia, J., Belvederi Murri, M. B., Erbuto, D., Pocai, B., Fioillo, A., Pompili, M., Flouri, E. & Amore, M. (2017). The relationship between childhood maltreatment and non-­suicidal self-­injury: A systematic review. Frontiers in Psychiatry, 8(149), 1–11. Shenk, C. E., Noll, J. G. & Cassarly, J. A. (2010). A multiple mediational test of the relationship between childhood maltreatment and non-­suicidal self-­injury. Journal of Youth and Adolescence, 39(4), 335–342. Spinazzola, J., Ford, J. D., Zucker, M., van der Kolk, B. A., Silva, S., Smith, S. F. & Blaustein, M. (2017). Survey evaluates: Complex trauma exposure, outcome, and intervention among children and adolescents. Psychiatric Annals, 35(5), 433–439. Stirling, A. E. (2009). Definition and constituents of maltreatment in sport: Establishing a conceptual framework for research practitioners. British Journal of Sports Medicine, 43, 1091–1099. 136

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Stirling, A. E. & Kerr, G. A. (2012). Perceived vulnerabilities of female athletes to the development of disordered eating behaviours. European Journal of Sport Science, 12, 262–273. Stirling, A. E. & Kerr, G. A. (2013). The perceived effects of elite athletes’ experiences of emotional abuse in the coach-­athlete relationship. International Journal of Sport and Exercise Psychology, 11(1), 87–100. Sundgot-­Borgen, J., Fasting, K., Brackenridge, C., Torstveit, M. K. & Berglund, B. (2003). Sexual harassment and eating disorders in female elite athletes: A controlled study. Scandinavian Journal of Medicine and Science in Sports, 13(5), 330–335. Sundgot-­Borgen, J. & Torstveit, M. K. (2004). Prevalence of eating disorders in elite athletes is higher than in the general population. Clinical Journal of Sport Medicine, 14(1), 25–32. Swannell, S., Martin, G., Page, A., Hasking, P., Hazell, P., Taylor, A. & Protani, M. (2012). Child maltreatment, subsequent non-­suicidal self-­injury and the mediating roles of dissociation, alexithymia and self-­blame. Child Abuse and Neglect, 36(7–8), 572–584. Symons, C., O’Sullivan, G., Borkoles, E., Anderson, M. B. & Polman, R. C. J. (2014). The impact of homophobic bullying during sport and physical education participation on same-­sex-­attracted and gender-­diverse young Australians’ depression and anxiety levels. Melbourne: College of Sport and Exercise Science, Victoria University and the Institute for Sport, Exercise and Active Living. Thomas, H. J., Connor, J. P., Lawrence, D. M., Hafekost, J. M., Zubrick, S. R. & Scott, J. G. (2017). Prevalence and correlates of bullying victimisation and perpetration in a nationally representative sample of Australian youth. Australian and New Zealand Journal of Psychiatry, 51(9), 909–920. Tonmyr, L., Thornton, T., Draca, J. & Wekerly, C. (2010). A review of childhood maltreatment and adolescent substance use relationship. Current Psychiatry Review, 6(3), 223–234. Ttofi, M. M., Farrington, D. P., Lösel, F., Crago, R. V. & Theodorakis, N. (2016). School bullying and drug use later in life: A meta-­analytic investigation. School Psychology Quarterly, 31, 8–27. Turner, H. A., Shattuck, A., Finkelhor, D. & Hamby, S. (2017). Effects of poly-­victimisation on adolescent social support, self-­concept and psychological distress. Journal of Interpersonal Violence, 32(5), 755–780. Van der Kolk, B., Roth, S., Pelcovitz, D., Sunday, S. & Spinazzola, J. (2005). Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma. Journal of Traumatic Stress, 18(5), 389–399. Vertommen, T., Kampen, J., Schipper-­van Veldhoven, N., Uzieblo, K. & van den Eede, F. (2018). Severe interpersonal violence against children in sport: Associated mental health problems and quality of life in adulthood. Child Abuse and Neglect, 76, 459–468. Weismoore, J. T.  & Esposito-­Smythers, C. (2010). The role of cognitive distortion in the relationship between abuse, assault, and non-­suicidal self-­injury. Journal of Youth and Adolescence, 39(3), 281–290. World Health Organisation (2019). Definition and typology of violence. Retrieved from: www.who.int/ violenceprevention/approach/definition/en/ Xiang Ng, Q., Zheng Jie Yong, B., Yin Xian Ho, C., Yutong Lim, D. & Yeo, W. (2018). Early life sexual abuse is associated with increase suicide attempts: An update meta-­analysis. Journal of Psychiatric Research, 99, 129–141. Yates, T. M., Carlson, E. A. & Egeland, B. (2008). A prospective study of child maltreatment and self-­ injurious behaviour in a community sample. Development and Psychopathology, 20, 651–671. Young, K. (2012). Sport, violence and society. New York: Routledge. Zatti, C., Rosa, V., Barros, A., Valdivia, L., Calegaro, V. C., Freitas, L. H., Ceresér, K. M. M., Rocha, N. S. D., Bastos, A. G. & Schuch, F. B. (2017). Childhood trauma and suicide attempt: A meta-­analysis of longitudinal studies from the last decade. Psychiatry Research, 256, 353–358.

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Part III

Athlete mental health

12 Mental health in sport Brad Donohue and Davy Phrathep

Introduction The positive association between mental and physical health suggests athletes are likely to be more mentally fit than non-­athletes due to their physical routines, particularly during childhood (Rodriguez-­Ayllon et al., 2019). However, the severity of psychiatric symptoms in athletes tends to be about the same as their non-­athlete peers (Donohue et al., 2004a; Gorczynski, Coyle & Gibson, 2017; Gulliver, Griffiths, Mackinnon, Batterham & Stanimirovic, 2015; Reardon & Factor, 2010; Rice et al., 2016). Moreover, athletes have consistently been indicated to underutilise psychological interventions when warranted (Gulliver, Griffiths  & Christensen, 2012). These findings have influenced the prioritisation of athletes’ mental health care through the development of practice guidelines, such as those established by members of the US-­based National Collegiate Athletic Association (NCAA; National Collegiate Athletic Association Sport Science Institute, 2016) and National Athletic Training Association (NATA; Neal et al., 2013), the International Society of Sport Psychology (Schinke, Stambulova, Si & Moore, 2017), and the European Federation of Sport Psychology (Moesch et al., 2018). The primary aims of this chapter are to: • • •

Review common factors that have been identified to influence the development and maintenance of mental health symptomology in athletes, Present a theoretical model to show how athletes’ mental health can be optimised through cognitive and behavioural skill development, and Summarise extant screening, engagement, and intervention programmes that have been found to assist athletes’ mental health care.

Understanding mental health in athletes Athletes and their non-­athlete counterparts experience most aspects of mental health symptomology similarly, although investigators have to reliably compare rates of mental health disorders between athletes and non-­athletes (Gorczynski et al., 2017). The contribution of sports participation to mental well-­being in athletes is generally positive (Eime, Young, Harvey, Charity & Payne, 2013). However, there is some evidence that, as compared with non-­athletes, athletes 141

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show higher levels of mental health disorders that are notoriously influenced by the evaluation of others, such as depression, anxiety, substance use, and eating disorders (Ford, 2007; Sundgot-­ Borgen & Torstveit, 2004; Wilson & Pritchard, 2005). For instance, athletes are increasingly being trained from a young age that peak performance depends on being attentive or dialed in to what parents, coaches, and teammates advise them to do (Watson, Connole  & Kadushin, 2011). This is an adaptive skill that is associated with success when feedback is accurate, important, and provided positively (Masland, Hooley, Tully, Dearing & Gotlib, 2014; Tzetzis, Votsis & Kourtessis, 2008). However, criticism is generally non-­productive when it is focused on the outcomes of performance (Kreiner-­Phillips & Orlick, 1993), generated from negative emotions (Mazer, Barnes, Grevious & Boger, 2013), or perceived as stressful, inherently exacerbating athletes’ mental health when performance is non-­optimal (Willis, Neil, Mellick  & Wasley, 2019). Criticism often influences athletes to focus on performance outcomes, which may lead to anxiety (Hill, Hanton, Matthews & Fleming, 2010), particularly when evaluations are unfair or outcomes are unpredictable. Furthermore, being consistently unable to tune out negative feedback may contribute to depression, anxiety, and substance-­use disorders, which are the most frequently reported mental health issues among athletes (Reardon et al., 2019). Heightened sensitivity to the opinions of others (Greer, 1983), when combined with frequent exposure to aversive criticism (Epting, Riggs, Knowles & Hanky, 2011), such as on social media (David et al., 2018), is likely to create stress (Sanderson, 2011). In this vein, social media usage has increased in athletes, and there is a growing culture that encourages athletes to express their perspectives on social justice issues (Sanderson, 2018), extending criticism of athletes beyond sport performance (Frederick, Sanderson & Schlereth, 2017). Youth athletes are increasingly specialising in one sport, hoping to gain a competitive edge (Brenner, 2016). This approach may increase vulnerability to stress and mental health symptomology if experimentation with other sports never occurs or negative life events eliminate competitiveness in the specialty sport (Jayanthi, Pinkham, Dugas, Patrick & LaBella, 2013). Upward movement in competitive level (e.g. college to professional) is another contextual factor potentially impacting mental health symptomology in athletes through elevations in stress (Lebrun, MacNamara, Rodgers & Collins, 2018). As the level of competition improves, athletes have less control of positive outcomes, which may create anticipatory anxiety and disappointment when expectations are not fulfilled (e.g. lower pay than expected, loss of starting position, not understanding trades to other teams, job insecurity; Russell, 2014; Turick & Paule-­Koba, 2017). These problems are exacerbated when feedback is inaccurate and indirect (Noblet & Gifford, 2002). Other unique contributors to mental health symptomology in athletes include sleep deprivation from erratic travel (Savis, 1994), negative consequences associated with maintaining weight that others indicate is optimum (Byrne & McLean, 2001), problems in relationships due to extended separation (Hurst, Baranik & Daniel, 2013), irritability due to illness and physical injury (Putukian, 2015), arguments with coaches (Smoll, Cumming & Smith, 2011), and maltreatment (Kerr & Stirling, 2019). Thus, athletes are at risk of experiencing taxing environmental stressors, harsh criticism, and negative evaluation for outcomes that are difficult to control or are unpredictable. As exemplified in an adaptation of the cognitive behaviour therapy triangle (i.e. the optimisation triangle; see Figure 12.1), when athletes’ thoughts, behaviours, and emotions are functioning optimally, they are able to manage stressors, permitting them to achieve optimal mental health and sport performance (Donohue et  al., 2018a). Therefore, optimisation of cognitive and behavioural skills should be emphasised in mental health programming, particularly because emotions are relatively difficult to control (Samoilov & Goldfried, 2006). This approach is more goal oriented than traditional mental health interventions that are focused on the amelioration of pathology (Adler & Seligman, 2016) and thus is a good fit for athletes. 142

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Optimum Thoughts

Stressors potentiated by nonconstructive criticism

Stressors potentiated by evaluation

Optimum Performance & Mental health

Optimum Behaviors

Optimum Feelings

Stressors potentiated by environmental demands Non-Optimal

Cognitive and Behaviour Skills

Optimal

Figure 12.1  Optimisation triangle. Source: Adapted from Donohue et al. (2018a).

Mental health screening/assessment in athletes Mental health screening procedures are customarily implemented to identify athletes who may benefit from comprehensive psychometrically validated assessment and potential mental health intervention (Kroshus, 2016). In practice, mental health screens are rarely systematically implemented within organisations. However, Tomalski et al. (2019) describe a model screening programme within the context of an athletic department within the United States. Workshops are implemented with all athletes in the system during their health evaluations to reduce stigma associated with mental health and increase athletes’ comfort with help seeking. The workshops emphasise group discussion about mental health concerns, prevalence of mental health issues, and methods of identifying mental health disorders. Additionally, athletes are recommended to watch a video that was developed by Athletes Connected1 (Kern et al., 2017). In this programme, video anecdotes of collegiate athletes’ experience with mental health concerns are shown to athletes, and the viewers are informed of available resources and how to approach teammates who are believed to be struggling with their mental health symptomology. Last, athletes are recommended to complete mental health screening procedures. The results of mental health screens help to efficiently identify student athletes who are likely to benefit from mental health intervention. Along this vein, athletic trainers are in an excellent position to administer mental health screening procedures under the oversight of appropriately licensed mental health professionals (Clement, Granquist & Arvinen-­Barrow, 2013), as they have frequent contact with athletes when treating sport-­specific risk factors (Rao & Hong, 2015). Sport-­specific screening measures for mental health symptomology have been psychometrically validated in athletes. Rice et al. (2019) developed the 12-­item Athlete Psychological Strain Questionnaire (APSQ) in a sample of 1,007 professional male athletes. The scale consists of three factors: 1) self-­regulation, 2) performance, and 3) external coping. Participants respond to items utilising a 5-­point frequency scale (i.e. 1 = None of the time; 5 = All of the time). For example, “About how often do you feel hopeless?” The APSQ has demonstrated good reliability and validity (Rice et al., in press; Rice et al., 2019). For instance, responses to this measure 143

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have been utilised to successfully identify high distress in athletes. Also, as APSQ scores increase, well-­being scores decrease, and psychiatric cut-­off scores are available. The Student Athlete Relationships Inventory (SARI; Donohue, Miller, Crammer, Cross & Covassin, 2007) is a 63-­item questionnaire that assesses sport-­specific relationship problems with teammates, family members, coaches, and non-­athlete peers. Hussey and colleagues (2019) examined the 16-­item SARI Family Scale, which includes five factors: 1) poor relationships and lack of support, 2) general pressure, 3) pressure to quit or continue unsafely, 4) embarrassing comments, and 5) negative attitude. Items range from one (extremely disagree) to seven (extremely agree). For example, “I don’t get enough encouragement from my family members”. The SARI Family Scale items have been found to predict significant elevations in psychiatric symptoms, and psychiatric cut-­offs scores are available. Donohue et al. (2019) and Donohue et al. (2018b) examined the utility of the Sport Interference Checklist (SIC; Donohue, Silver, Dickens, Covassin  & Lancer, 2007) in identifying collegiate athletes and circus students and professionals, respectively, who may be likely to benefit from mental health programming. The SIC includes 26 items for each of three scales: 1) problems in sport competition scale, PSCS; 2) problems in sport training scale, PSTS; and 3) desire for sport psychology scale, DSPS. The PSCS and PSTS scales are designed to assess sport-­specific problems that have been found to interfere with performance during training and competition. A 7-­point scale (1 = extremely disagree, 7 = extremely agree) is used to rate these items (e.g. negative thoughts about personal performance). DSPS items are scored on a dichotomous scale (yes/no) to determine the interest of athletes in pursuing professional intervention with regard to the respective item. The SIC has been indicated to significantly predict significant psychiatric symptomology in collegiate athletes, and psychiatric cut-­off scores are available. The aforementioned instruments are capable of reliably identifying significant psychiatric symptomology in both collegiate athletes (i.e. SARI, SIC) and professional athletes (APSQ, SIC), and item responses are directly relevant to sport performance and likely to assist athletes who do, and do not, meet psychiatric thresholds. Therefore, all athletes should be invited to participate in evidence-­supported workshops (Kern et al., 2017) and interviews (Donohue et al., 2016) to learn more about mental health and encourage their participation in psychologically based programmes that are capable of concurrently optimising mental health and sport performance. Such inclusivity assists in destigmatising mental health symptomology and protects the confidentiality of participating athletes because their reason for participation cannot be deduced as elevated mental health symptomology. This approach is also more economical due to the prevention of potential future mental health problems in athletes, particularly those who are assessed to evidence subclinical mental health symptomology. Mental health screens also establish baselines, much like the impact for concussions (Covassin, Elbin, Stiller-­Ostrowski & Kontos, 2009). When assessment is desired along the continuum of mental wellness, other psychometrically validated assessments should be considered, including the Sport Mental Health Continuum Short Form (Foster  & Chow, 2019) and the Sport Psychology Outcomes and Research Tool (Hansen et al., 2019).

Mental health awareness and engagement interventions in athletes Studies have indicated the importance of mental health awareness (Breslin, Shannon, Haughey, Donnelly & Leavey, 2017) and engagement in the athlete population (Donohue et al., 2004b, 2016; Gulliver, Griffiths  & Christensen, 2012). Breslin and colleagues (2017) conducted a systematic review to determine the effect of programmes aimed at improving mental health 144

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knowledge and help-­seeking among sports coaches, athletes, and officials. Ten studies were identified. Of these, six were determined to improve mental health referral efficacy, and three were determined to improve knowledge of mental health disorders. Seven studies did not report effect sizes for their outcomes, limiting clinically meaningful interpretations. Also, seven studies evidenced a high risk of bias. Consequently, Breslin et al. (2017) concluded that while some of these programmes evidenced support for increasing mental health literacy and support for athletes, coaches, and officials, few demonstrated methodological quality, and most suffered a high risk of bias. Programmes have addressed mental health education in sport contexts. For instance, Kern et al. (2017) utilised an educational overview of mental health, videos of former student-­athletes’ struggles with mental illness, and a discussion with athletes portrayed in the videos. Results from pre-­and post-­surveys indicated that this education-­based intervention may be helpful in stigma reduction. Van Raalte, Cornelius, Andrews, Diehl and Brewer (2015) evaluated a web-­based education and training approach through the use of a multimedia, interactive website (www. SupportForSport.org) to assist student athletes in making effective mental health referrals. In a controlled field trial with a sample of 153 student-­athletes, results indicated that the website resulted in enhanced mental health referral knowledge and efficacy compared to a control group. Liddle and colleagues (2019) developed and evaluated a sport-­specific mental health literacy intervention called Help Out A Mate (HOAM). This programme was implemented in adolescent males from a community football club in Australia. Components focused on improving attitudes towards people with mental health disorders. Liddle and colleagues (2019) randomised participants to either HOAM or a waitlist control group. Measures assessed at baseline and post-­intervention included knowledge of signs and symptoms of mental illness, intentions to provide help to a friend who may be experiencing a mental health problem, attitudes that promote problem recognition and help-­seeking, confidence to provide help, personal help-­ seeking intentions, and psychological distress. Outcomes were consistently more efficacious for participants who were assigned to HOAM. Mental health intervention engagement strategies in collegiate athletes have also been evaluated in controlled trials (Donohue et al., 2004b, 2016; Gulliver, Griffiths & Christensen, 2012). These studies show engagement strategies (i.e. discussing the benefits of sport psychology, normalising mental health symptoms/substance use, mental health literacy) are relatively effective in motivating athletes to verbally commit to mental health programming and in improving attitudes about mental health. However, these interventions have not resulted in significantly greater attendance in psychologically based intervention programmes than control conditions.

Programmes found to improve mental health symptoms in athletes Several interventions have been examined in athletes who were not formally assessed for mental health diagnoses, with most focusing on skill development or mindfulness. For instance, cognitive behavioural therapy2 (CBT) includes emotional regulation skills training (thinking objectively with a positive bent when difficult situations are experienced), awareness and restructuring of maladaptive automatic thoughts, and behavioural skill acquisition (e.g. communication skills, pleasant activity scheduling, time management). Although CBT is one of the most utilised interventions in the world, its scientific evaluation in athletes is limited to a single uncontrolled case trial involving a female collegiate rower who was treated for major depressive disorder (Gabana, 2017) and a controlled multiple baseline study involving four female hockey players who were not assessed for mental health diagnoses (Didymus & Fletcher, 2017). Relevant to the 145

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female rower, informal outcomes and process measures were consistently positive. The hockey players’ appraisals of organisational stressors were substantially improved. Voelker, Petrie, Huang and Chandran (2019) developed and evaluated Bodies in Motion (BIM), an eating disorder prevention programme for use in female collegiate athletes who were not diagnosed with a mental health disorder. The programme attempts to assist the participants in managing healthy ways to manage sociocultural and sport-­specific body pressures. This prevention intervention is based on cognitive dissonance theory3 and mindful self-­compassion.4 Intervention components are aimed at engaging athletes in behaviours that challenge societal appearance norms and address appearance ideals specific to sport. The investigators utilised quasi-­experimental design methodology to compare participants who received BIM with those who received a wait list control on several measures (i.e. thin-­ideal internalisation, body appreciation, body satisfaction, shape and weight concerns, bulimic symptomatology, negative affect, muscular-­ideal internalisation, positive affect, sport-­specific body pressures). Results indicated that the participants in BIM showed greater improvements for internalised thin appearance ideals as compared with control group participants. In the Mindfulness-­Acceptance-­Commitment (MAC) approach, optimal performance is conceptualised as being influenced by the athlete’s ability to remain non-­judgmentally present while persisting with the task at hand, managing internal discomfort without losing present-­ moment focus on environmental demands of performance (Gross et  al., 2016). MAC components address cognitive skills through psychoeducation interventions and behavioural skills through mindfulness exercises. Gross et al. (2016) evaluated MAC and psychological skills training5 in a randomised control trial (pre-­/post-­/one-­month follow-­up) involving 18 female collegiate athletes who were not diagnosed with a mental health disorder. Psychological symptoms6 and sport performance were assessed utilising psychometrically validated subscales. Results indicated that MAC was more efficacious than psychological skills training in reducing substance use and hostility, and participants in MAC demonstrated improvements in most of the other measures. Psychological skills training was also efficacious across time in some measures, suggesting this intervention has promise in mental health promotion as well. Mindful sport performance enhancement (MSPE) is a mental training skills intervention developed by Kaufman, Glass and Arnkoff (2009). It is an extension of mindfulness-­based stress reduction and mindfulness-­based cognitive therapy and emphasises mindfulness skills relevant to sport performance. Chen and colleagues (2018) utilised an uncontrolled pre-­/post-­intervention experimental design to evaluate MSPE in an amateur baseball team (n = 21). Mental health measures included anxiety, depression, sleep disturbance, and eating disorder symptoms. Improvements were found for flow state and eating disorder symptoms. Rational emotive behaviour therapy (REBT) is based on the premise that beliefs about events lead to emotional and behavioural reactivity (Turner, 2016). In the sport context, athletes are taught to restructure their beliefs to more rational ones so they can face situations with more functional cognitions, emotions, and behaviours. Turner and colleagues (Cunningham & Turner, 2016; Davis & Turner, 2019; Turner & Barker, 2013; Turner, Ewen & Barker, 2018) have utilised both uncontrolled and controlled case study methods to consistently demonstrate that REBT interventions are efficacious in reducing irrational beliefs and anxiety symptoms that negatively influence sport performance in athletes who are not assessed to evidence mental health disorders. The Optimum Performance Programme in Sports (TOPPS) is a sport-­specific adaptation of family behavioural therapy7 (Azrin et al., 1994) that has been shown to be efficacious in collegiate athletes who have been formally diagnosed with mental health disorders in two controlled (Chow et al., 2015; Donohue et al., 2018a) and four uncontrolled clinical trials (Donohue et al., 146

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2015; Galante, Donohue & Gavrilova, 2019; Gavrilova, Donohue & Galante, 2017; Pitts et al., 2015). Role-­playing, programme assignments, and significant other support (e.g. from family, coaches, teammates) are extensively used to assist skill acquisition. The program includes contingency management, goal inspiration, communication skills training, self-­control, performance progress reviews, environmental control, appreciation exchanges, functional analysis, dream job, job getting, and financial management. In collegiate athletes with no, single, and multiple mental health diagnoses, participants in TOPPS significantly decreased psychiatric symptoms; improved relationships with coaches, family, and teammates; and decreased factors interfering with sport performance more than participants in traditional campus counselling up to eight months post-­baseline in a randomised clinical trial (Donohue et al., 2018a). In this trial programme, satisfaction was significantly higher for participants who received TOPPS, and greater outcome improvements occurred as diagnostic severity increased. Outcomes for TOPPS were not improved, relative to traditional counselling, in frequency of unprotected sex and frequency of substance use at eight months post-­baseline. Results of the aforementioned trials support that transdiagnostic optimisation intervention approaches (i.e. interventions that target optimisation in multiple mental health disorders concurrently) may be promising in athletes. For instance, in the Donohue et  al. (2018a) study, participants were not required to evidence a mental health disorder, yet 80% of the participating athletes were assessed to evidence a current or past mental health disorder, most often substance use or mood and anxiety disorders. Therefore, CBT and mindfulness-­based psychological programmes may be capable of addressing both prevention and intervention concurrently, which may lower implementation costs and stigma associated with athletes’ pursuit of mental health care. This transdiagnostic optimisation approach is consistent with enhanced health care access through socialised medicine (Light, 2003).

Future directions Research specific to mental health in sport is rapidly growing. However, there are a number of areas that warrant future exploration. First, it is important that etiological studies be conducted to reliably determine factors that bring about mental health symptomology in athletes. In this vein, it is important to determine if athletes and non-­athletes from comparable backgrounds and of comparable characteristics evidence different levels of stressors and symptomology across psychological disorders. Sport-­specific mental health screening measures will need to be psychometrically validated, particularly in youth populations, and clinical trials are needed in youth, collegiate, and professional athletes. As mental health screens are developed, it is imperative that athletic administrators and policymakers allocate appropriate resources to permit administration of these tools across all athletes in their respective organisations. The administration of these tools should be engaging and occur within a culture of optimisation that is based on available science. Last, screens should be used to effectively match athletes to mental health prevention and intervention options that are also supported by science. The research standards for clinical trials involving athletes must also improve, including the use of blind assessors, psychometrically validated questionnaires, biological measurements of substance use, social validation measures/consumer satisfaction assessment, measurements of treatment integrity, and extended follow-­up assessment. Indeed, most of the interventions mentioned previously were examined in uncontrolled efficacy trials involving adults and lack scientific rigour. Moreover, athletes were rarely assessed for mental health disorders in the trials that were reviewed (i.e., those involving TOPPS). As evidence-­supported preventions and interventions develop, there will be a need to evaluate methods of training providers in their 147

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use through large-­scale effectiveness trials. Further, to strengthen mental health programme implementation efforts, it will be necessary to find ways to better integrate the work of non-­ licensed and licensed sport psychology professionals within university systems and sport organisations. Utilising a transdiagnostic optimisation approach to mental health programming offers great advantages along these lines. Indeed, certified mental performance consultants (CMPCs) and licensed sport psychologists/mental health professionals could initiate the administration of sport-­specific mental health screens, assessments, and preventions/interventions in teams. In this approach, CMPCs can receive supervision from mental health professionals for mental health conditions, and mental health professionals who do not have sufficient training in sport performance can receive supervision for sport performance from CMPCs. Training programmes should be developed within the context of technological integration (i.e. video and telephone conferencing, web-­based tutorials), such as those critically evaluated by Gulliver et al. (2012) and Van Raalte and colleagues (2015). Last, since evidence-­based mental health programmes for athletes are increasing in outcome support, it is important that sport organisations require the implementation of these practices.

Notes 1 The Athletes Connected programme is a collaboration between the University of Michigan School of Public Health, Depression Centre, and Athletic Department to increase awareness of mental health issues, reduce the stigma of help-­seeking, and promote positive coping skills among student athletes (Athletes Connected, n.d.). 2 Cognitive behavioural therapy is a form of psychological treatment that focuses on changing thinking and behavioural patterns to bring about greater reinforcement. 3 Cognitive dissonance theory suggests that we have an inner drive to hold our attitudes and behaviour in harmony and avoid disharmony. 4 Mindful self-­compassion is a mindfulness programme that trains people to be more self-­compassionate. 5 Psychological skills training is a form of psychosocial intervention for the enhancement of athletic performance, usually through skill building. 6 Depression, eating concerns, substance use, generalised anxiety, hostility, social anxiety, distress index, family distress, and academic distress. 7 Family behavioural therapy (FBT) emphasises cognitive and behavioural skill development through role playing, therapeutic assignments, and utilisation of family support systems.

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13 Suicide among athletes Ashwin L. Rao

Introduction Suicide is a global health problem impacting communities and individuals of all backgrounds. Every 40 seconds, an individual dies from suicide (World Health Organisation, 2018). When an athlete dies from suicide, family, friends, coaches, teammates, and staff making up their community experience a profound sense of preventable loss, grief, and surprise. Explaining such deaths is difficult. Athletes are perceived as among the healthiest and most successful members of their communities, and it is nearly impossible to reconcile this identity against their vulnerability to mental illness. Media reports covering these tragedies broaden and magnify the impact of athletic suicide. In recent years, the suicide deaths of many prominent athletes across sports have brought this concern to the forefront of discussions around safety and well-­being (Associated Press, 2012; Bishop, 2018; CBS Sports, 2012; Fagan, 2017; Hürriyet Daily News, 2012; Miller, 2016; National Hockey League, 2011). These prominent deaths also suggest that no sport, culture, gender, identity, or ethnicity is spared from the threat of suicide. In some instances, these stories are complicated by substance abuse, violent behaviour, financial hardship, and deviant behaviour, but in other instances, athletes die from suicide without clear explanation. Sports medicine researchers have begun to consider the actual risk of suicide in athletic communities, asking whether athletes are at the same, greater, or lesser risk of suicide than their non-­athletic peers (Baron, Hein, Lehman & Gersic, 2012; Gouttebarge, Frings-­Dresen & Sluiter, 2015; Lehman, Heln & Gersic, 2016; Rao, Asif, Drezner, Toresdahl & Harmon, 2015; Sabo, Miller, Melnick, Farrell  & Barnes, 2005). While research efforts are of limited scope, many are calling for mental health to be given its own platform for consideration, discussion, and management and for this discussion to be supported by scholarship.

Defining suicide Suicide may be defined as a death caused by self-­directed injurious behaviour with intent to die as a result of that behaviour (Centres for Disease Control, 2018a). A suicide attempt involves a self-­directed, non-­fatal, yet potential injurious event with an intent to die. Suicidal ideation involves the thought, consideration, and/or planning of a suicide attempt. Not all self-­inflicted 153

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deaths are suicides. For example, accidental drowning, without the intent to take one’s own life, would not qualify as suicide. Thus, non-­suicidal self-­injury may be defined as behaviour that is self-­directed and deliberately results in injury, without suicidal intent.

Scope There were 44,965 reported suicide deaths (123/day) in 2016 for the United States alone, where suicide represents the 10th leading cause of death (Centres for Disease Control, 2018b). For every suicide death, 12 others attempt suicide (Centres for Disease Control, 2015). While females are more likely to attempt suicide, males are more likely to die from suicide, because they typically use lethal means such as a firearm. While adolescents (age