How ATs Can Better Manage Stress

May 27, 2020 by Claire Higgins

Editor’s note: In honor of Mental Health Month, NATA is conducting a weekly mental health blog series throughout May to examine different facets of this topic and how they impact athletic trainers and their patients. This article focuses on the resources available to better manage stress, and how to identify when support after a stressful situation is needed.

Athletic trainers are able to notice something is “off” with a patient – maybe they are stressed, more quiet than usual or just seem down – and ATs know when to intervene and refer them to a mental health professional. But, it isn’t always easy to recognize when something is off with one’s self.

Starting a new job, a lack of work-life balance or handling a catastrophic event with a patient on the field – any of these situations, no matter how big or small they seem, can cause an athletic trainer to veer from their normal routine, to feel “off,” and it’s important for ATs to understand what to do when this happens.

For some, it could be as simple as eating healthier snacks and getting more sleep, but other situations, such as losing a patient or coworker, might require more attention. ATs Care, for example, is a go-to resource for NATA members who find their normal responses to stress disrupted. Finding someone to talk to is often the best place to start.

“[Athletic trainers] are quite often the heartbeat of the team, and if we don’t know how to manage our stress levels, how can we preach that to our athletes?” said Lovie Tabron, ATC, ATs Care Commission District Nine representative. “If we’re not prioritizing ourselves and our mental health, then we are not whole to help our patients.”

ATs Care is a peer-support program for athletic trainers and athletic training students to connect with other ATs trained in providing peer support to deal with the aftermath of a critical incident. Since its inception in 2016, ATs Care team members, who are organized throughout the country by state, district or region, have provided outreach services to more than one-third of the NATA membership.

How a response to a critical incident presents itself emotionally and physically in a person varies.

“Trauma is dependent on who is experiencing it … no event is too big or too small to be concerned about,” said ATs Care Commission Chair Dave Middlemas, EdD, ATC, CCISM.

ATs Care team members are trained in critical incident stress management to identify the cognitive, emotional, behavioral and physical responses a person is experiencing and address those by talking through them. They also work in partnership with clinical mental health professionals to connect people with for further assistance.

“We call it emotional first aid,” said Betsy Esposito, MS, ATC, an ATs Care co-team leader in New Jersey.

Understanding when emotional first aid is needed, when stress presents itself differently in every person, comes down to knowing one’s bodies. Middlemas, Tabron and Esposito all said knowing when daily routines and typical moods veer from normal is the biggest indicator.

Middlemas, for example, said hypervigilance or hyperactivity can indicate stress negatively affecting a person if they are typically level-headed and organized. In contrast, lethargy, withdrawal from activities and peers can also indicate stress.

Tabron recommended implementing an internal checklist, a tool she uses personally to know how she is feeling emotionally and physically and when something may have triggered a stress response.

Create a list that outlines cognitive, physical, emotional and behavioral feelings that represent a normal state of being. If there is a day, couple of days or a week when an item on that checklist can’t be checked off, Tabron said that’s when an athletic trainer should seek out support.

For Tabron, for example, feeling upset, unmotivated and unfocused or feeling a lack of purpose, are all indicators that something is “off” and seeking peer support is her next step.

By addressing these responses head on and openly, Tabron and Esposito said it will help normalize feelings of doubt or stress.

“There is still a huge stigma [around mental health] … but the more everyone talks about it, the more we normalize connecting over these things,” Esposito said.

How often to run through an internal checklist is dependent on stress levels or the demands put on the body. For example, Tabron said, a collegiate athletic trainer working with the football team may run through their list more often during the season, when stress levels are likely heightened. When they are in the off-season, conversely, they may not need to check in as often.

ATs Care also provides a self-care checklist infographic handout that can be useful in checking in, as well. Find that and other resources about understanding stress management as athletic trainers at the ATs Care resource webpage. The NATA Secondary School Athletic Trainers’ Committee is also working on wellness self-assessment resource for ATs. Look for more information about this resource in the coming weeks.

ATs Care is a great starting point for athletic trainers who aren’t able to check off each item on their internal checklists, and getting in touch with a team member is simple. Visit the ATs Care contact page or email the commission directly. Requests are vetted to the appropriate regional or district team and a team member will reach out via email or phone. Athletic trainers can connect with team members for an intervention over the phone, but are also welcome to meet in person, if schedules and social distancing mandates allow.