Table 2 Summary of included studies
From: The Mental Health of Elite-Level Coaches: A Systematic Scoping Review
Study | Study Design; MMAT Quality Score | N (male: female) | Themes | Sport; country | Definition of elite | Key findings |
|---|---|---|---|---|---|---|
Ã…kesdotter et al. [108] | Quantitative, Cross-sectional; 40% | 34 (23:11) | Alcohol-Related Disorders Anxiety, Depression, Eating Disorders, Substance-Related Disorders | Various; Sweden | International | Of the 34-treatment seeking high-performance coaches, 93% were diagnosed with any anxiety disorder, 28% were diagnosed with a major depressive disorder (single episode or recurrent), and 14% were diagnosed with an alcohol-related disorder. Less than 5 coaches were diagnosed with either an eating, bipolar, or substance-related disorder |
Baldock et al. [10] | Qualitative; 100% | 8 (8:0) | Wellbeing | Soccer; United Kingdom | National, Professional | Coaches largely appraised performance, organisational and personal-related stressors as threats. These demands were predominantly met with ineffective coping strategies, which subsequently led to negative states of wellbeing. Conversely, when effective coping strategies were employed, coaches usually experienced high levels of wellbeing |
Baldock et al. [83] | Mixed-Methods, Longitudinal; 80% | 18 (18:0) | Burnout, Wellbeing | Soccer; United Kingdom | National, Professional | Using four time points across a competitive season, coaches reported moderate levels of wellbeing and low to medium levels of burnout. Wellbeing was at its lowest at the beginning of the season, whilst emotional exhaustion and depersonalisation were highest at the end of the season |
Balk et al. [90] | Quantitative, Longitudinal; 60% | 31 (30:1) | Wellbeing | Various; Australia and The Netherlands | International, National | Emotional detachment (the previous day), sleep quality and sleep duration contributed towards a coach’s experience of positive affect the following morning. Coaches who reported greater positive affect were also more likely to experience high levels of work engagement |
Bentzen et al. [97] | Qualitative; 40% | 4 (4:0) | Burnout | Not Specified; Denmark and Norway | Professional | Organisational and performance-related stressors contributed towards a shift in the quality of motivation maintained by a coach. A shift from autonomous to controlled motivation operated as an antecedent to burnout. Coaches also experienced a range of symptoms associated with burnout, including affective, cognitive and behavioural changes |
Bentzen et al. [96] | Quantitative, Longitudinal; 40% | 299 (274:25) | Burnout (Emotional Exhaustion) | Various; Norway and Sweden | National | A significant increase in emotional exhaustion was reported by elite-level coaches over the course of a season. Although the majority of the sample reported low levels of exhaustion throughout the season (71%), 24.4% of coaches met the criteria for high levels of exhaustion. High workload and work-home interference were associated with high levels of exhaustion, and high levels of recovery, intrinsic regulations and identified regulations were associated with low levels of emotional exhaustion |
Bentzen et al. [87] | Quantitative, Longitudinal; 40% | 343 (313:30) | Burnout, Wellbeing | Various; Norway and Sweden | National | A small to moderate increase in burnout and decrease in wellbeing occurred in elite-level coaches over the course of a competition season. No significant relationship was identified between burnout and season length, thus suggesting that the length of a season may not be a contributing factor towards burnout |
Bentzen et al. [88] | Quantitative, Longitudinal; 40% | 299 (274:25) | Burnout, Wellbeing | Various; Norway and Sweden | International, National | Coaches who reported high levels of job insecurity in the middle of the season were more likely to experience low levels of mental wellbeing and high levels of exhaustion and cynicism at the end of the season. Job value incongruence did not significantly impact levels of wellbeing and burnout over the season |
Bentzen et al. [24] | Qualitative; 100% | 6 (5:1) | Wellbeing | Soccer; Norway | National | Coaches experienced a decrease in occupational wellbeing when fired. They also experienced a range of negative (e.g. frustration) and positive (e.g. gratitude) emotional responses throughout the process |
Carling et al. [82] | Quantitative, Experimental; 20% | 6 (N/A) | Anxiety, Sleep | Soccer; France | National | The developed music intervention helped significantly shorten the time required to fall sleep, as well as reduce symptoms of anxiety among elite-level coaches |
Carson et al. [92] | Quantitative, Cross-sectional; 40% | 128 Elite (464 Overall) (N/A) | Wellbeing | Not specified; Australia | International, National | Australian high-performance coaches generally reported high levels of wellbeing on the Warwick-Edinburgh Mental Wellbeing Scale (M = 51.7, SD = 8.3) |
de Sousa Pinheiro et al. [94] | Quantitative, Longitudinal; 40% | 26 (26:0) | Wellbeing | Soccer; Brazil | National | Coaches reported significantly higher levels of stress in competition and during training periods when compared with vacation periods. No significant differences in stress levels were observed between competition and training periods. With regards to recovery, results were only significantly higher in vacation periods compared to competitive periods |
Foretić et al. [109] | Quantitative, Case Study; 40% | 1 (N/A) | Anxiety | Handball; Qatar | National, Professional | Coaches experienced significantly greater post-match anxiety when compared with anxiety levels post-training. These findings were physiologically corroborated with biomarkers, as cortisol, alpha-amylase and heart rate levels were significantly higher prior to matches as opposed to training. These findings demonstrate evidence of a ‘pre-competitive’ effect amongst elite-level coaches |
Gencay and Gencay [101] | Quantitative, Cross-sectional; 40% | 65 (55:10) | Burnout | Judo; Turkey | National, Professional | Elite-level judo coaches experienced medium levels of burnout on average. No significant associations were identified between gender; however, a positive correlation was discovered between emotional exhaustion and years of coaching experience. Coaches were also more likely to be protected from burnout if they perceived themselves as being supported by their sports administrators |
Georgios and Nikolaos [102] | Quantitative, Cross-sectional; 20% | 164 (164:0) | Burnout | Track & Field; Greece | National | Hardiness, competitive trait anxiety and satisfaction with support all negatively predicted a coach’s perception of stress, whilst hardiness and satisfaction with support negatively predicted burnout. Competitive trait anxiety and perceived stress also positively predicted burnout |
Hägglund et al. [84] | Qualitative, Experimental, Longitudinal; 60% | 18 (7:11) | Wellbeing | Athletics and Figure Skating; Sweden | International, National | The mindful self-reflection intervention contributed towards an increase in practices associated with wellbeing (e.g. self-compassion) amongst elite-level coaches. These behaviours were still being implemented at 6- and 12-month follow-ups post-intervention |
Hassmén et al. [98] | Mixed-Methods, Longitudinal; 20% | 8 (8:0) | Burnout | Soccer; Sweden | National | Coaches experienced fluctuating levels of emotional exhaustion and depersonalisation over the 10-year study period. Withdrawal from the profession led to significant reductions in emotional exhaustion |
Hjälm et al. [99] | Quantitative, Cross-sectional; 80% | 47 (47:0) | Burnout | Soccer; Sweden | National, Professional | 71% of coaches managing soccer teams from the Women’s Premier League in Sweden reported moderate to high levels of emotional exhaustion. Conversely, only 23% and 45% of coaches managing teams within the Swedish Men’s Premier League and Men’s Second League reported moderate to high levels of emotional exhaustion respectively |
Kaski and Kinnunen [93] | Quantitative, Cross-sectional; 40% | 499 (384:115) | Burnout; Wellbeing | Not Specified; Finland | International, National | Although Finnish coaches generally experienced good levels of wellbeing (work engagement), 22% of coaches met the criteria for mild symptoms of burnout, and 2% met the criteria for severe symptoms of burnout. A lack of job resources was found to predict burnout and work engagement more effectively than the presence of job demands |
Kegelaers et al. [11] | Quantitative, Cross-sectional; 40% | 119 (97:22) | Anxiety, Depression, Risky Alcohol Consumption, Sleep, Psychological Distress | Not Specified; Belgium and The Netherlands | International, National | 39.5% of the coaching sample reported symptoms associated with depression or anxiety, and 19.3% indicated experiences of distress. 19.3% of coaches met the caseness criteria for adverse alcohol use and 25.2% reported sleep disturbance |
Kellmann et al. [95] | Quantitative, Longitudinal; 60% | 6 (6:0) | Wellbeing | Australian Football; Australia | National, Professional | On average, coaches maintained low to moderate levels of stress over the course of a season, whilst recovery levels were low to moderate and declined throughout the season. Vacations also seemed to contribute to a temporary recovery effect for coaches. Sleep quality however was consistently low throughout the season |
Kenttä et al. [86] | Qualitative, Case-Study; 100% | 1 (0:1) | Wellbeing | Swimming; Sweden | International, Olympic | The coaches relieved from their duties experienced compromised mental wellbeing (cognitive and emotional) including symptoms associated with anxiety and distress post-termination. Effective psychological skills and strong social supports were perceived as important protective factors during this process |
Kenttä et al. [85] | Qualitative; 60% | 37 (0:37) | Wellbeing | Various; Sweden | National | Although female coaches largely experienced the same challenges as male coaches, a unique set of sex-specific stressors emerged from the study, including proving oneself to male counterparts, lack of acceptance in the coaching role, and receiving less support at home due to family-related responsibilities. Participants revealed adapting to the stereotypical male culture of sport in order to protect their mental wellbeing, as opposed to challenging cultural norms |
Kim et al. [111] | Quantitative, Cross-sectional; 60% | 69 (53:15 – 1 gender diverse) | Depression | Soccer and Various; New Zealand | International, National | 14.1% of coaches met the criteria for at least moderate symptoms of depression. Contemplating retirement and having a family history of a mood disorder was significantly associated with symptoms of moderate or major depression. A strong association was also discerned between the total and severity of daily life hassles and symptoms associated with depression |
Lee and Chelladurai [89] | Quantitative, Cross-sectional; 40% | 430 (278:152) | Burnout (Emotional Exhaustion), Wellbeing | Not Specified; U.S | NCAA Division I | Positive affectivity predicted 3 forms of emotional labour (surface acting, deep acting, genuine expression), whilst negative affectivity predicted surface acting amongst coaches. Positive affectivity, negative affectivity, surface acting, and genuine expression all predicted emotional exhaustion too. The relationship between surface acting and emotional exhaustion was also significantly moderated by emotional intelligence |
Lee [103] | Quantitative, Cross-sectional; 60% | 203 (115:88) | Anxiety, Burnout (Emotional Exhaustion) | Various; U.S | NCAA Division I | Goal incongruence positively predicted and coping efficacy negatively predicted subjective ratings of anxiety amongst NCAA Division I coaches. In addition, self-reported levels of anxiety also positively predicted self-reported emotional exhaustion |
Longshore and Sachs [91] | Mixed-Methods, Experimental; 20% | 20 (8:12) | Anxiety, Wellbeing | Not Specified; U.S | NCAA Division I | Coaches experienced significantly less positive affect, negative affect and trait anxiety following the Mindfulness Training for Coaches Program. Greater emotional stability contributed towards enhanced wellbeing and coach-athlete interactions |
Lundkvist et al. [100] | Qualitative; 100% | 8 (8:0) | Burnout | Soccer; Sweden | National | Two profiles of burnout were identified in elite-level coaches. Those who burned out due to the performance culture of elite sport experienced behavioural changes (e.g. passive and asocial). Conversely, coaches who experienced considerable work-home challenges (i.e. life-situation profile) experienced high levels of exhaustion (e.g. fatigue and mental overload) |
Lundkvist et al. [104] | Quantitative, Cross-sectional; 60% | 97 Elite (336 Overall) (N/A) | Burnout (Emotional Exhaustion) | Soccer; Sweden | International, National, Professional | In alignment with MBI and clinical cut-offs, this cohort of coaches presented low levels of emotional exhaustion in comparison to normative samples |
Nikolaos [105] | Quantitative, Cross-sectional; 20% | 170 (170:0) | Burnout | Basketball; Greece | National | On average, coaches experienced moderate levels of emotional exhaustion and depersonalisation, and low levels of personal accomplishment. Coaching level, social support and coaching issues significantly predicted the stress appraisal, whereas stress appraisal, social support and coaching issues significantly predicted burnout |
Olusoga et al. [13] | Qualitative; 100% | 12 (6:6) | Wellbeing | Various; United Kingdom | International, Olympic | Coaches revealed that perceived stress contributed towards negative affective states, including feelings associated with emotional fatigue and depression |
Olusoga and Kenttä [45] | Qualitative, Case Study; 80% | 2 (2:0) | Burnout | Not Specified, Sweden | National, Olympic | Burnout generally occurred due to a lack of recovery time for coaches, as opposed to the overload of performance, organisational and personal-related stressors. Departing the coaching role and possessing adequate social support were key factors in recovering from burnout |
Pilkington et al. [12] | Quantitative, Cross-sectional; 40% | 78 Coaches (252 including High-Performance Support Staff) (59:19) | Anxiety, Depression, Risky Alcohol Consumption, Sleep, Psychological Distress, Wellbeing | Not Specified; Australia | International, National | 43.6% of coaches met the probable caseness criteria for anxiety and depression, whereas 48.1% and 10.3% met the caseness criteria for risky alcohol consumption and psychological distress respectively. 34.6% of coaches also revealed they had sought psychological treatment at some stage throughout their life |
Roberts et al. [110] | Qualitative, Case Study; 100% | 1 (1:0) | Depression, Risky Alcohol Consumption | Not Specified, United Kingdom | International | The head coach described concealing their experiences of depression and alcoholism due to the stigma associated with mental ill-health in elite sport. The coach also revealed a desire to conceal their mental health status in order to ensure future employment was a possibility |
Ruddock et al. [78] | Quantitative, Cross-sectional; 0% | 142 (N/A) | Anxiety, Burnout, Depression, Psychological Distress | Australian Football; Australia | National, Professional | Findings revealed that emotional exhaustion was the only component of burnout that could predict levels of anxiety, depression and stress amongst professional AFL (Australian Football League) coaches. Greater levels of emotional exhaustion contributed towards higher levels of anxiety, depression and stress |
Ruddock et al. [79] | Quantitative, Longitudinal; 20% | 115 (115:0) | Anxiety, Burnout, Depression, Psychological Distress | Australian Football, Australia | National, Professional | Emotional exhaustion, stress and overall DASS and GHQ scores significantly increased from pre-season to mid-season. Emotional exhaustion was also identified as the strongest predictor of mental ill-health, as high levels of stress, anxiety and depression were all significantly predicted by emotional exhaustion |
Ruddock et al. [80] | Quantitative, Longitudinal; 20% | 50 (N/A) | Anxiety, Burnout, Depression, Psychological Distress | Australian Football; Australia | National, Professional | Concomitant increases of emotional exhaustion, depression and stress occurred between February and August when contract renewal was approaching. These levels started to decrease in November once the competitive season had concluded |
Ryska [106] | Quantitative, Cross-sectional; 40% | 345 (267:78) | Burnout | Various; U.S | NCAA Division I | Coaches generally reported low levels of burnout. Those who pursued prestige goals and public relations using a high strategic-low collaborative relationship were more likely to experience burnout, whereas those who pursued personal growth and athletic excellence with a low bureaucratic-high collaborative leadership were less likely to suffer burnout |
Seo et al. [107] | Quantitative, Cross-sectional; 60% | 210 (151:59) | Burnout | Taekwondo; South Korea | National | Workplace conditions negatively predicted burnout, whereas burnout positively predicted presenteeism in South Korean National coaches. Those operating within a positive working environment were less likely to suffer burnout and presenteeism |
Smith et al. [81] | Quantitative, Cross-sectional; 0% | 21 (7:14) | Eating Disorders | Cheerleading; U.S | NCAA Division I | 38.1% of coaches were considered to be at risk of an eating disorder. Pathogenic behaviours included risk of using laxatives, diet pills or diuretics (33.3%), loss of 20 or more pounds in a month (9.5%), risk of vomiting (9.5%) and risk of binge eating (4.8%) |
Smith et al. [113] | Quantitative, Cross-sectional; 40% | 35 Elite (202 Overall) (25:10) | Various Mental Illnesses | Various; United Kingdom | Olympic, Paralympic | 45.7% of high-performance coaches from the sample had experienced or were currently experiencing a mental disorder |
Vinberg et al. [112] | Quantitative, Cross-sectional; 40% | 401 Coaches (317:79–5 missing) | Gambling Disorders | Various; Sweden | National, Professional | 6% of coaches demonstrated at-risk gambling behaviours |