A golf anxiety intervention

I’ve just been reading a (very!) newly published paper about a pre-performance routine intervention in a golfer experiencing anxiety. Li (2023) presents a case study on Judith, a 23 year old competitive golfer who is seeking strategies to improve her focus, and would like assistance in implementing a pre-performance routine to combat her lack of focus. She thinks that her choking when faced with a competitive situation is likely a result of anxiety, low confidence and a lack of perceived control.

For this case study, Li (2023) uses a cognitive-behavioural approach. The idea behind this approach is that an individual’s cognitive activity can significantly affect their behaviours and subsequent emotions. The idea that the way in which a situation is perceived alters behaviour is widely supported (e.g., Hofmann et al., 2012). It is also suggested that cognitive-behavioural strategies are of particular importance for athletes. Early and Grady (2017) suggest that the cognitive-behavioural aspects of deliberate practice in sport results in athlete’s brains being somewhat different to their non-athlete counterparts. In their 2017 paper, Early and Grady list possible circumstances for cognitive-behavioural interventions, and developing concentration and focus and increasing confidence are among the extensive list.

The cognitive-behavioural consultation model (CBCM; Meyers et al., 1996) is the model of practice chosen by Li (2023). This approach is collaborative, involving the golfer and their support team (likely to include a coach, co-ordinator, psychologist etc.), and has a focus on mental skills training. There are seven steps to the CBCM:

1. Consultation orientation

2. Sport familiarisation

3. Evaluation and assessment (i.e., needs analysis)

4. Goal identification

5. Group or individual intervention

6. Effectiveness evaluation

7. Reassessment of goals

The needs analysis stage of Judith’s case study involves triangulating methods with the aim of identifying causal factors of her choking. Li (2023) opted to start with the retrospective self-report questionnaire. This made Judith identify her best and worst performances, with a series of questions relating to each experience. Next, a semi-structured interview was conducted. The four questions enabled the researcher to “diagnose” issues with Judith’s pre-performance, taking this information forward to inform the intervention. The final stage of the needs analysis process was the use of the revised competitive state anxiety inventory-2 (CSAI-2R; Cox et al., 2003).

From the needs analysis process, it was conceptualised that the main issues in Judith’s pre-performance were distraction and loss of attentional control. These issues induced other cognitive and somatic issues, such as anxiety, distress, indecision, fear of failure, unrealistic expectations, and choking. Previous research (e.g., Mesagno, 2019; Hill et al., 2011) supports the notion that pre-performance routines prevent choking instances in golfers. The mechanisms behind these findings lie in the distraction model of choking. Research in other sports, such as basketball free-throw, also demonstrate the benefits of pre-performance routines and outline that these can reduce choking by preventing distraction (e.g., Mesagno & Mullane-Grant, 2010).

Li (2023) opted to use the five-step strategy for self-paced skills (Singer & Suwanthada, 1986) as the pre-performance routine intervention for Judith. The five steps in this approach are:

1. Ready

2. Image

3. Focus

4. Execute

5. Evaluate

For Judith specifically, the intervention consisted of breathing and relaxation, cognitive restructuring, imagery, and a holistic putting feel. The intervention was conducted over a ten-week period, with two competitions taking place during this time. After practice or competition, Judith was asked to complete a reflective diary discussing key aspects of her performance. Additionally, a semi-structured interview and the CSAI-2R were used at the conclusion of Week 10 to compare results with baseline, and assess the effectiveness of the intervention.

Li (2023) does not include results in the published paper. Additionally, the objective performance of the golfer was not measured. Any future researchers may opt to record objective golf performance alongside measuring the effectiveness of an intervention programme, employing a longitudinal design in doing so. Despite these limitations, this paper is an example of how cognitive-behavioural interventions can be implemented in applied sport settings.