The guru-driven nature of sport psychology has contaminated the field and how it is perceived, evaluated, and valuated by coaches, athletes, and decision makers in organizations who may want to utilize the services of sport psychology practitioners. This chapter provides a foundational and fundamental rationale for advancing evidence-based and validated athlete assessment and intervention protocols. The prevalent approach to applied sport psychology is practitioner-centered. The American Board of Sport Psychology (ABSP) mission is to advance practice, education, and training standards in the field of applied sport psychology as well as provide licensed psychologists the opportunity to achieve board certification in sport psychology. Sport psychologists and sport psychology practitioners must distinguish themselves from coaches and other practitioner-advisors who work with athletes. Sport psychology offers practitioners of highly disparate education, training, experience, and credentials an unparalleled opportunity to break into the elite strata of sports.

The Critical Moment (CMT) testing paradigm introduces psychological stressors to practice settings by attaching physical, psychological, and material value to what would otherwise be routine moments during training. CMT brings accountability to practice sessions by documenting performance throughout a training period or on demand during specific testing epochs. The CMT creates psychological stress in a performance situation that otherwise might be perceived as routine and innocuous by an athlete. CMT paradigms are sport specific and can be customized so as to simulate important actions or tasks that are common and important to a particular sport. Anecdotally, one will frequently observe that athletes of all levels also are motivated intrinsically to compete and want to perform well and win, even in intra-squad competitive events or tasks that are ancillary or irrelevant to real game statistical performance.

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.

Mental imagery (MI) or visualization can be considered the go-to mental training (MT) method and is used by the vast majority of sport psychology practitioners. MI is addressed in the context of the Theory of Critical Moments and athlete’s profile (AP) models of peak performance construct bases and the brain-heart-mind-body-motor dynamics they advance in regard to intervention efficiency and efficacy. Athlete is tested for Visualization Responsivity (VR) using the Carlstedt Protocol Visualization Responsivity Test-Athlete Version (CPVR-A). This chapter provides some consecutive autonomic nervous system (ANS)-heart rate variability (HRV) reports that emanate from a professional tennis player who was high in hypnotic susceptibility (HS)/subliminal attention (SA), namely the baseline condition, positive-negative and relaxation visualization scenario-based HRV responses. It presents an MI intervention efficacy case study in the context of actual competition using a repeated A-B-A design. Variance explained in a visualization-based or associated outcome measure should be the intervention efficacy benchmark.

Heart rate variability (HRV) measures have been found to consistently predict macro- and micro-level sport-specific outcomes, including performance during critical moments as well as reflecting differential states of attention, intensity, and mental control, especially when an athlete is under competitive pressure. This chapter explores and explicates HRV in the context of pre-intervention assessment of athlete mind-body-motor and outcome responses and attempts to arrive at an athlete’s individual zone of optimum functioning (IZOF), as well as criterion reference athlete’s profile primary higher-order (AP PHO) constellations with autonomic nervous system (ANS)/psychophysiological measures in both training and real competition. The polar system allows for real-time wireless and telemetry HRV data acquisition and analyses opening up the possibility of isolating specific inter-beat intervals during action. Such a capability facilitates micro-analyses of HRV and heart rate deceleration (HRD) on an unprecedented level, since investigations of HRV/HRD can be carried out during high-intensity training and competition.

Neurocognitive testing (NCT) and quantitative electroencephalography (qEEG) are brain assessment procedures that are used to investigate relationships between cortical functioning and context-specific outcome measures to arrive at clinical diagnoses or better informed patient and client evaluations. Research is ongoing to test the premise that NCT and qEEG can serve as reliable criterion-referenced measures for athletes profile primary higher order (AP PHO) constellations, heart rate variability (HRV) responding and eventually macro- and micro-performance outcome. Low/high ratio (L/H) was associated with numerous conceptually relevant NCT tests, including motor tapping variability, motor tapping, and switching of attention completion time. This chapter reviews the results from pilot research encompassing over 50 athletes from the sports of baseball, tennis, and ice hockey prior to presenting a case study of an ex-world class professional tennis player who underwent NCT and qEEG as part of the American Board of Sport Psychology-Carlstedt Protocol (ABSP-CP) pre-intervention evaluation process.

Behavioral-Motor-Technical (BMT)-based intervention attempts to help support an athlete’s mental game using exposure, confrontation, threshold, and learning principles to improve attention, motor control, and self-confidence, as well as reduce nervousness associated with pressure moments of competition. BMT-based intervention is a direct approach to mental training (MT). Conceptually, BMT MT’s utility and potential to enhance psychological performance is based on motor learning, technical repetition, and exposure/habituation principles. The central nervous system mechanisms that are thought to be associated with BMT-MT-induced habituation or inoculation to competitive stress are discussed under brain-based interventions of the athlete’s profile (AP) brain-heart-mind-body conceptual model and construct bases. The goal of BTM-MT is to consolidate optimum technical and motor patterns in long-term procedural memory as well as repetitively attempt to demonstrate peak technical performance under greatest situational pressure, first in training and then during official competition.

Technical and focus threshold testing is a low-tech method that is used to help determine the extent to which an athlete exhibits technical/motor control and concomitant focus or attention in the context of sport-specific task challenges of increasing level of difficulty. It is an important first step in on-the-playing-field assessment of technical/physical and psychological performance, allowing a coach and sport psychology practitioner to quantify technical-psychological balance or how much of an athlete’s performance equation can be explained on the basis of mind-body factors. It provides criterion-referencing for in-office self-report and psychological test scores as well as practitioner intuition. A major issue in the technical-focus threshold equation involves temporal dynamics or time that it takes to achieve enduring change (TAC). TAC can be operationalized as the amount of time that it takes to achieve neuronal consolidation of a technical skill, context-specific attention span, or any other performance-relevant psychological tendency or behavior.

Heart rate deceleration biofeedback (HRD BF) is a relatively unknown intervention whose origin can be traced to an extensive body of research on pre-stimulus or pre-action cardiac activity. HRD BF is a very mechanistic approach, whose effects can be immediately documented independent of speculative interpretive components associated with more cognitively based interventions. BF attempts to induce or shape mind-body responses by first showing baseline autonomic and/or central nervous system activity as reflected in waveform oscillations or other representations that are observable on a computer screen, and then reinforcing prescribed performance or wellness-related target psychophysiological responses. In multi-modal HRD BF, video and visualization components are integrated into the mental training process. In terms of intervention efficacy, the tested player won more and lost fewer games in the HRD BF compared to the no-intervention condition. Conceptually consistent intervention efficiency and efficacy findings support its utility as an athlete assessment and intervention approach.

Neurofeedback (NF) is a brain-based procedure that has made its way into the sport performance mental training (MT) arena. Athlete-specific NF protocols have also been used in an attempt to enhance performance. However, there are conceptual and methodological issues and problems associated with NF, more so in sport performance contexts. The current state of NF mirrors that of the field of sport psychology in general. According to the Dietrich’s Transient Hypofrontality Hypothesis (THH), the brain must make do with a finite amount of metabolites and blood flow. The THH can be difficult to test due to motion artifact issues associated with most brain imaging instruments, including positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). THH-based NF may have the potential to reprogram/program performance adaptive brain-heart responses in athletes who are burdened with the worst athlete’s profile (AP) by taking the frontal lobes out of the performance disruption equation.

Practitioners should be aware of and critically appraise the conceptual bases and construct validity of an intervention or mental training (MT) method. Intervention dose–response relationships (IDRR) and time to achieve enduring change (TAEC) is a conceptual issue that is closely related to temporal properties of MT. Evidence-based approaches to MT and intervention must take temporal and time to achieve enduring change parameters into account using the systematic methodologies. Ecological validity is a vital prerequisite for high evidentiary athlete assessment and intervention. The Polar heart rate variability (HRV)/heart rate deceleration (HRD) paradigm allows for more extensive and time-locked predictive validity statistical analyses so that in-the-moment MT over the course of entire official games/matches/competition can be delineated and quantified in terms of MT’s predictive validity.

This chapter presents interventions and mental training (MT) modalities in order of the hypothesized probability that engaging in a select method will lead to a successful outcome per Carlstedt Protocol (CP) efficacy criteria. There are numerous intervention and MT modalities to choose from, both as a practitioner and an athlete. The American Board of Sport Psychology-Carlstedt Protocol (ABSP-CP) approach to intervention and MT is based on the athlete’s profile (AP) model of individual differences that has isolated key primary higher-order (PHO) factors that are intimately related to critical components of performance: attention, physiological reactivity, and strategic planning/coping, all of which play a mediating role in the intervention and MT process. The chapter addresses interventions in the context of ABSP-CP perspectives, procedures, and methodologies, and, particularly, how a specific MT technique can be applied/used to facilitate in-the-moment peak performance as reflected in heart rate deceleration (HRD).

Multi-modal approaches to mental training (MT) involve the incorporation of more than one intervention method in attempts to enhance performance. Intervention amenability and compliance relative to multi-modal MT, as when using singular modalities alone, need to be seriously considered. Multi-modal MT can be very straightforward and designed to specifically address psychological or technical issues or goals independently. This chapter provides an example of a select individualized multi-modal intervention. As with all MT modalities, multi-modal methods must be documented and scrutinized for efficiency and efficacy. Heart rate variability (HRV) and autonomic nervous system (ANS) reports are used to determine intervention efficiency and efficacy. Multi-modal mental training (MMMT), as with any form of intervention that has established efficiency and efficacy, should be carried out independently by athletes who travel to competitions or are assisted by coaches and/or team mates in the absence of a sport psychology practitioner.

This introduction presents an overview of key concepts discussed in the subsequent chapters of the book. The book presents information and approaches that are critical to high-standard evidence-based applied sport psychology. Evidence-based practice and empirically validated assessment and interventions have become catch-phrases in psychology. It exposes practitioners, educators, and students to an integrative, interdisciplinary, and systematized approach to athlete assessment and intervention. The book is also designed to foster interdisciplinary understanding, information sharing, and integrative approaches to athlete assessment, mental training, and outcome research. It focuses on the American Board of Sport Psychology-Carlstedt Protocol (ABSP-CP), a system of athlete assessment and intervention that since originally being conceptualized has been applied to hundreds of athletes. The book is replete with extensive case studies of actual athlete assessment and intervention, bringing to life the perspectives, models, methodologies, and procedures in the form of real data sets and their acquisition, analysis, and interpretation.

This chapter presents a validated multifaceted assessment and intervention protocol that has been used on hundreds of athletes over the last 15 years. It provides data and findings on athletes who have experienced the Carlstedt Protocol (CP), and recommends for the integration of procedures and methodologies that are vital to evidence-based applied sport psychology, and the credibility of the field of sport psychology/biofeedback and its practitioners. In addition to guiding biofeedback, the established athlete’s profile is a strong predictor of intervention amenability and compliance tendencies, pain thresholds, attentional control during competitive stress, coachability, and the placebo-nocebo effects. During critical moments, athletes possessing the most negative or disruptive constellation of primary higher-order (PHO) factors exhibit heart rate acceleration (HRA) prior to action, while those having the most facilitative or protective constellation continue to demonstrate heart rate deceleration (HRD).

Video-based mental programming (VBP) is a more direct intervention modality that accesses and uses visual processing to facilitate, especially motor and technical, performance; although it can also be used in attempts to increase motivation, emotional engagement, and attain individual zone of optimum functioning (IZOF) established levels of physiological reactivity. VBP can be viewed as a very direct mental training approach, one that circumvents esoteric and extraneous intervention procedures that are more difficult to assess in terms of efficiency and efficacy. It can also be used as a stress test, whereby an athlete’s underlying psychophysiology is monitored while watching his or her self-performance over the course of a complete game or match. Baseline heart rate variability (HRV) profiles should be compared with intervention-induced HRV to establish intervention efficiency. The chapter also presents a real case study to illustrate the VBP intervention process and an outcome associated with it.

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.

The establishment of construct validity in the context of sport psychological assessment and intervention requires the identification of valid functional mind-body origins or bases of athlete psychological responses and associated performance tendencies during training or competition. Finding additional links between heart rate deceleration (HRD) and concomitant brain activity parameters leading up to action that are also associated with performance outcome would be an extension finding in the construct validation process. Irrespective of whether a practitioner subscribes to the Brain-Heart-Mind-Body-Motor (BHMBM) and its interrelated Athlete’s Profile (AP) and Theory of Critical Moments (TCM) models of peak performance, construct validity should be considered when deciding what assessment instrument to use or intervention to apply. The chapter also presents a comprehensive and integrative explication of key components of the Carlstedt Protocol’s (CP) validated athlete assessment and intervention system.

One of the goals of the intake process is to establish rapport with an athlete, a psychological dynamic that facilitates trust and motivation to participate in eventual assessments and interventions. In an evidence-based approach, the initial intake session is structured and standardized. Components of the intake include the initial response to a client who is interested in sport psychological services, preintake assessment test battery, the first face-to-face contact and discussion of the initial test results, on-the-playing-field evaluation, and the culminating consulting and intervention strategy. This chapter focuses on to the intake session conversation, and provides some additional information on the Internet-based test battery and its relevance to the consulting process. The failure to extend the intake evaluation process to the playing field can have lasting deleterious consequences for an athlete and negatively impact a practitioner’s effectiveness and credibility.

Athletes who are high in hypnotic susceptibility (HS) are most amenable to hypnosis/self- and active-alert hypnosis. The feeling that one has when under sport and performance-specific hypnosis is one of mental calmness. Once alert-calmness has been attained using sport-specific inductions, as reflected in changes in autonomic nervous system (ANS) responses from the baseline to hypnosis condition, active-alert hypnosis is used to raise activation or intensity levels and prime motor-technical responses. The American Board of Sport Psychology-Carlstedt Protocol (ABSP-CP) approach to interventions uses heart rate variability (HRV) to test efficiency for all mental training modalities and routinely assesses mental imagery/visualization ability, a correlate of HS/subliminal attention (SA) using HRV. Hypnotic procedures have much potential as a mental training intervention, provided that they are not applied indiscriminately. Athletes who score high in HS or analogue measures, SA, or absorption are usually good candidates for self-and active-alert hypnosis.

This chapter presents the athlete’s profile (AP) in an applied context and reviews the primary higher order (PHO) measures that it encompasses and their impact on performance. It describes test instruments, applications/administration, psychometrics and methodology. The AP model is a conceptual and explanatory framework that predicts athlete psychological performance tendencies during pressure situations of competition. The conceptual origins of the AP can be traced to the High Risk Model of Threat Perception (HRMTP) and its isolation of the three so-called subject variables, hypnotic susceptibility (HS), neuroticism (N), and repressive coping (RC). These measures were shown to interact to mediate maladaptive cognitive processing/attention, physiological reactivity, and subliminal coping and resulting symptoms and/or illness. As such, the AP battery should only be administered in the context of a comprehensive athlete evaluation and intervention efficacy testing process.

The manipulation of cerebral laterality is a validated brain-based experimental procedure that can be used to induce rapid changes in emotional states associated with potentially disruptive athlete’s profile (AP) constellations as well as brain hemispheric shifts in the preaction to action transition. Priming or stimulating the right visual and blocking the left visual field using special goggles/glasses is an experimental cerebral laterality manipulation (CLM) intervention that has been associated with demonstrated intervention efficiency and efficacy. CLM manipulation can also be directly applied to facilitate the well-documented pre-action relative to left-to-right hemispheric shifts associated with peak performance responses, especially in athletes who have an ideal AP or more ambiguous hemispheric valence profiles. The manipulation of visual-field input leads to activation of the contralateral brain hemisphere and unequivocal evidence of intervention efficiency that is hard to demonstrate for most mental training modalities.