Psychophysiological stress testing (PST) should be routinely administered to all athletes at intake. This test provides an additional layer in the evidence hierarchy by extending Athlete’s Profile Primary Higher Order (AP PHO) constellation self-report and behavioral measures to underlying mind-body responding. Feelings of discomfort, worry, nervousness, and overall stress are expected to heighten in athletes with the most detrimental AP PHO constellation or in athletes who score high for neuroticism/subliminal reactivity (N/SR), and induce changes in heart rate variability (HRV) that are associated with increases in sympathetic nervous system (SNS) activity. While differential levels of activation are usually necessary for sport performance, in the context of a static situation and cognitive stressors, greater low frequency (LF) and accompanying SNS is hypothesized to be disruptive and interfere with mental tasks, such as strategic planning as a precursor to motor action.

This chapter presents an introduction to advanced gold standard accountability procedures for athlete assessment and intervention. The best way to demonstrate the validity of an assessment battery or efficacy of an intervention is through an accountability process. Relative to athlete assessment, accountability can and should be demonstrated in the construct validity of a specific psychological, behavioral, or psychophysiological measure that is being assessed. The field of applied sport psychology is replete with research-based systems, eclectic and hybrid athlete evaluation, and mental training methods, as well as extreme Guru-propagated, “analyze and cure-all” schemes that promise or guarantee incredible success. The preceding data set is consistent with individual athlete differential mind-body responses that have been observed in extensive previous intervention efficacy research. Practitioners should generate and maintain an accountability database throughout the course of their work with an athlete.