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  • Arousal Psychological or physiological state of being alert.

  • Depersonalization Being detached from oneself.

  • Derealization Feelings of unreality.

  • Empathy Being sensitive to and vicariously experiencing the feelings, thoughts, or motives of another person.

  • Holistic Related to healing; a holistic approach includes all parts of the healing system—the mind and the body—in the healing process.

  • Mood Emotional state (e.g., happy, sad).

  • Paresthesias Numbness or tingling sensations.

  • Proactively Acting in advance to deal with an expected difficulty; anticipatory.

  • Proxemics Communication expressed through the space between two people as they interact.

  • Rapport The harmonious or synchronous relationship of two or more people who relate well to each other.

  • Subclinical The early stages or a very mild form of a condition.

  • Suicidal ideation Serious thoughts about committing suicide.

  • Tolerance Reaction to a drug is progressively reduced thereby requiring an increase in concentration to achieve the desired effect.

  • Withdrawal Symptoms that occur due to the decrease or discontinuation in intake of drugs.



After reading this chapter, you will be able to:

  1. Describe the role and scope of practice of the athletic trainer in the referral process.

  2. Identify professionals within a mental health referral network.

  3. Establish a mental health referral network.

  4. Identify signs and symptoms of distress and mental disorders that warrant referral.

  5. Describe the mental health referral process.


Amelia is a sophomore collegiate volleyball player who has sustained a severe sprain of her ankle. Amelia is currently beginning rehabilitation, and her athletic trainer recognizes that she may be having difficulty adjusting to the injury. During one of the rehabilitation sessions, the athletic trainer mentions to Amelia that she seems to lack energy and appears to be distracted. Amelia does, in fact, feel lethargic and is thankful that her athletic trainer noticed. Because of the rapport that the athletic trainer has built with Amelia over the season, Amelia feels comfortable confiding in the athletic trainer. Amelia shares that she is not sleeping well and is constantly worrying about how the injury is going to influence her athletic career; this is affecting her ability to attend class, and when she does attend, it is difficult for her to concentrate. Amelia also shares that she feels like she is no longer an athlete because she is not able to participate in her sport. The athletic trainer recognizes that Amelia's injury situation is interfering with her daily functioning and understands that Amelia could be in need of a mental health referral.


This chapter focuses on the athletic trainer's role and scope of practice in the identification and management of psychosocial distress in athletes with whom they work. The athletic trainer's role as part of a multidisciplinary sports medicine team is emphasized. Although it is clearly beyond the scope of practice for athletic trainers to diagnose mental health ...

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