developing a behavior health plan for college athletes

Developing a Behavior Health Plan for College Athletes

Marcy Buselli MS ATCR. Mark Laursen MS ATCBoston UniversityAthletic Training Services

Boston University Athletic Training Services

Overview

• Values

• Philosophy

• Team

• Making Connections across campus


Components of the System

1. Coach Education2. Sports Psychology

– Performance enhancement

3. Patient education 4. Nutrition 5. Prevention and Screening6. Psychosocial Counseling

– Mandatory vs Voluntary

7. Medical Management – Medication and return to activity

8. Case Management9. Confidentiality and Communication


Coach Education

• Group Meetings

• Individual Basis

• Challenges


Sports Psychology

• Performance Enhancement

• Policies and Requirements• Doctoral student with exception• Mandated on campus supervision weekly• Review of scope of practice• Referral policy and chain of command• Documentation

• Cost


Patient Education

• First meeting of the year

• Team/Group meetings– Specific conditions/diseases

• Life skills (mandatory in athletics)

• Campus Policies and Procedures


Nutrition Fitness Center


Health Service Athletics PERDDining ServicesSargent College


Nutrition Fitness Center Services



Nutrition Fitness Center Services


Group CounselingSargent Choice Dining services

Individual Counseling

PERD Classes


Group CounselingSargent Choice Dining services

PERD ClassesIndividual Counseling


Health Service Athletics Dining ServicesSargent College

PERD


Prevention and Screening

• Process

• “Red Flags”


Red Flags for behavioral health Do you ask these questions?

• Current Medications

• Current Eating Practices– Attitudes and Behaviors

• Females – Menstruation Hx

• Body Measurements

• Personal Health History

• Other Topics


Prevention and Screening

• Process

• “Red Flags”

• Future plans


Psychosocial Counseling

• Campus– Student Health Services- Behavioral Medicine– Danielsen Institute Clinic – Psychological Services Center– Center for Anxiety and Related Disorders– University Chaplains– Center for Psychiatric Rehabilitation

Campus ResourcesYour Concern Type of Service Whom to Call Name of

ServiceDescription/ Information

Contact Information

Help managing depression and school work

Mental Health/ Counseling

Mitzi Kane (Patient Care Coordinator)

BU Student Health Services- Behavioral Medicine

•Individual Counseling and Psychotherapy•Psychopharmacological evaluation and treatment•Group Therapy•Emergency support

881 Comm. Ave W.Boston, MA 02215

617-353-3569(24 hr on call)

www.bu.edu/shs/behavioral

George StavrosDanielsen Institute Clinic

•Assessment•Individual, group, and family therapy

185 Bay State RoadBoston, MA 02215

617-353-3047

www.bu.edu/danielsen

Life Skills Support

Dori HutchinsonAndrea Bengtson(Clinical Coordinator)

BU- Center for Psychiatric Rehabilitation

•Skill building and support services for individuals with serious psychiatric challenges•Individual recovery and rehabilitation services•Individual case management

940 Comm. AveBoston, MA 02215

617-353-3549

For Information about other services:www.bu.edu/cpr/services

Academic Support(see section on

Academic Resources for information on Educational

Resource Center)

Lorraine Wolf Office of Disability Services

Services/ Accommodations Provided-•Note taking•Accessibility Services•Assistive Technology•Interpretation•Tutoring•Study Skills Support

19 Deerfield Street (2nd Floor)Boston, MA 02215

Ph: 617-353-3658

(V/TTY)

www.bu.edu/disability

http://www.bu.edu/shs/behavioral


http://www.bu.edu/danielsen

http://www.bu.edu/cpr/services

http://www.bu.edu/disability

Campus ResourcesYour Concern

Type of Service

Whom to Call Name of Service Description/ Information

Contact Information

How to talk to a friend who might be cutting himself/ herself. Where can they get help.

Mental Health/ Counseling

Mitzi Kane (Patient Care Coordinator)

BU Student Health Service- Behavioral Medicine

•Individual Counseling and Psychotherapy•Psychopharmacological evaluation and treatment•Group Therapy•Emergency support

881 Comm. AveBoston, MA 02215

617-353-3569(24 hr on call)

www.bu.edu/shs/behavioral

George StavrosDanielsen Institute Clinic

•Assessment•Individual, group, and family therapy

185 Bay State RoadBoston, MA 02215

617-353-3047

www.bu.edu/danielsen

Valerie Wilson/ Lisa Smith

BU Psychological Services Center

•Assessment•Individual Psychotherapeutic treatment

648 Beacon St, 5th FloorBoston, MA 02215

617-358-4290

www.bu.edu/psc

Information

How to help someone in distress-www.bu.edu/helpinfo





http://www.bu.edu/psc

http://www.bu.edu/helpinfo


Psychological Referral Mandatory vs Voluntary

Voluntary

Department ID

Mandatory

Self referral

Voluntary

Voluntary

Crisis

Mandatory

Mandatory


Medical Management

• Team Physician

• Athletic Trainer

• Behavioral Health Provider

• Contracts– Team Physician– Athletic Trainer– Student-athlete– Coaches – Nutrition– Behavioral health


Eating Disorders EvaluationAnd Treatment

Athletic Trainer

Other Nutritionist

Behavioral Health

Team Physician

StudentAthlete


Behavioral Contract for the 2009-2010 Academic Year

• I, ___________________, agree that my dietary habits and exercising may be detrimental to my health. My goal over the upcoming academic year is to compete to the best of my ability in a manner that will not compromise my health and safety.

• To this end, I am entering into this agreement with Boston University Athletic Training Services. • I agree to meet weekly with Health Care Provider (HCP) for weight checks and to monitor my

progress. Meetings may be more frequent if the HCP feels that is warranted. I may also opt to meet more frequently if I feel it is needed. These visits may be spaced out later in the year as my goals are achieved and maintained as determined by HCP.

• I agree to meet at least twice per month with a sports nutritionist to review dietary goals. • I agree to meet with a psychologist once per week. Meetings may be more frequent based on

recommendations by the mental health care provider and/or HCP. • We have determined that my health may become compromised if my weight drops below X pounds.

If at anytime over the next year my weight drops below X pounds, I will be held from participation in any team events, including practice and competition for at least 2 weeks as determined by HCP. I will attend practices and competitions but will not be allowed to practice or compete.

• If my weight drops below X pounds, I agree to blood tests to assess several aspects of my health as determined by HCP. At the end of this 2 week period, HCP will decide on my return to participation based on my weight and any tests results if available.

• I will not be allowed to participate fully with the Boston University athletic team until my weight is above X pounds.

• I will adhere to workouts set forth by the coaching staff and agree not to work out on my own without their consultation. I may be allowed partial participation including limited workouts if my weight is above X pounds, but not participate fully until my weight reached X pounds.

• If I miss any of these mandatory appointments, I will be subject to temporary disqualification from team activities as determined by HCP, and my eating disorder team (nutritionists, mental health provider, and athletic training staff). Frequent breach of this contract will result in permanent disqualification. _________________________ _______ ______________________ _______ Student-athlete Date Team Physician Date_________________________ _______ Athletic Trainer Date


Case Management

Classification Managed by Support from

Level 1 Individual AT Case Manager

Level 2Case

ManagerAdministration/ Team physician

Level 3University

Case Manager

Case Manager Administration

Team physician


Confidentiality and Communication

• Who needs to know what?


Who needs to be informed by Athletic Training Services

Always Sometimes Rarely

•AT coordinating care

•AT admin

•Team physician

•Case coordinator

•Behavioral Health–Nutrition

•Coaches

•Athletic Administration–Academic Services

•Other ATs

•Residence Life

•Dean of Students

•Teammate

•Parents


Confidentiality and Communication

• Who needs to know what?

• How a condition can affect our practice as athletic trainers?

• 5 minute meetings

• Patient centered challenges

• Chain of command

• Documentation


Please see athletes’ General Medical file for additional diagnosis and treatment information.

Note: Additional information is sensitive in nature please respect the athletes’ confidentiality.


Scenario (#1)

• It’s the fall Semester for a junior women’s track athlete. Her coaches call the athletic trainer who coordinates the care for the team concerned with her recent weight loss.


Scenario (#1)Coach calls concerned/recent weight loss

• Gather more information– Specific incidents, chart information: BMI, Family hx, personal hx

• Initiate contact with the patient– Coach asks for athletic trainer to speak with SA

• Screen patient

• Referral policy


Nutrition

Medical Management

Medical Management

Behavioral Health


Scenario (#1)Coach calls concerned/recent weight loss

• Gather more information

• Initiate contact with the patient

• Screen patient

• Referral policy

• Communication


Scenario (#2)

• Pre-participation paperwork is received for a transfer wrestling student-athlete. The student shows up for physicals.


Scenario (#2)Pre-participation paperwork/physicals.

• Information– Medication

• Screen patient– Team physician, Athletic trainer, Leadership

• Referral and treatment plan – Contract, on or off campus

• Communication


Thank YouMarcy Buselli MS ATCR. Mark Laursen MS ATCBoston UniversityAthletic Training Services

developing a behavior health plan for college athletes

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