| Performance outcomes | Competition results and performance-related outcomes, assessed through case studies, pre-post designs, controlled studies, or randomised controlled trials | Whether performance changed after psychological support. A Sports Medicine review found positive effects in some studies, but the overall evidence for effectiveness with elite athletes is very weak and effects vary widely. | The review identified only four study designs (six case studies, two one-group pre-post studies, one controlled study, two waitlist trials), which makes it hard to credit results to the psychologist specifically. |
| Athlete wellbeing | Validated overall-wellbeing measures taken before and after psychological skills training, third-wave interventions, or positive-psychology interventions | Likely shifts in overall wellbeing. A meta-analysis reported pooled standardised effects of 0.78 for psychological skills training, 0.32 for third-wave approaches, and 0.58 for positive-psychology interventions. | Success depended on adapting the intervention, coach and teammate support, and how well the practitioner connected with athletes. Busy schedules and complex content cut participation. |
| Retention and continuation in sport | Continued participation, enjoyment, burnout, adjustment difficulties, and early recognition of mental ill-health | Whether support is associated with enjoyment, wellbeing, and staying in the sport. Published guidance holds that earlier-career mental-health support likely promotes retention and help-seeking. | This describes likely benefits, not proof of cause. Burnout, adjustment, sporting conditions, and organisational factors all shape retention. |
| Help-seeking and service uptake | Formal help-seeking rates, referral uptake, service contacts, and barriers or facilitators to access | How many athletes seek help and why. Across 11 studies with 3,415 athletes, about 22.4% formally sought help (95% CI 16.2 to 30.2). | Stigma, fear of deselection, confidentiality worries, low mental-health literacy, and sport culture all affect uptake, so a change alone does not show effectiveness. |
| Mental-health literacy and engagement | Workshop reception, player engagement, willingness to support or refer teammates, and intended or actual use of wellbeing services | Whether a team-based programme is accepted. An evaluation with elite rugby union players in Ireland found it was well received and engaging, though players stayed reluctant to seek help. | Positive reception does not establish lasting behaviour change. Shame around help-seeking persisted, and longer-term embedded activity was recommended. |
| Team-affiliated vs independent support | Preference for consulting team staff versus other sources, and numbers seeking help from team staff or mental-health professionals | Whether players see in-house staff as acceptable. Japanese male rugby players were significantly less likely to prefer team staff and fewer sought help from them. | Low uptake may reflect confidentiality concerns, role conflict, stigma, or fear of selection consequences rather than poor support. |