Mental health and resilience in organised sport: The Ahead of the Game program

Participants assigned to the intervention group (which include adolescent males, their parents, and their coaches) will be exposed to at least one workshop from a possible four which will be determined by their sporting club. Adolescents will be exposed to: 1. Your Path to Success in Sport (YPTSS): This workshop targets key psychological skills identified in sport-based resilience literature and aims to help adolescent males cope with adversity through explicit sport-based examples. This component will be delivered via a brief, team-based, face-to-face workshop (approx. 45 min) supported by six internet-based (website/mobile application) modules lasting approximately 15 minutes each. The workshop is framed around expectations versus reality in the process of achieving one‘s goals to identify inevitable adversities that adolescents are likely to face in and outside of sport. The workshop also allows participants to sign up for the internet-based modules during the workshop, and to complete the first module within the session, to enhance subsequent uptake and engagement. All workshops will be delivered by a trained member of the research team (including Mental Health First Aid training) in a changing room or clubhouse of the participants sporting club, or if this is unavailable, at a central location (such as the University of Wollongong). Adolescents are then free to undertake the internet-based modules at home in their own time using the aheadofthegame.org.au website. The internet-based modules address: (i) problem solving; (ii) controlling the controllables; (iii) managing your thoughts; (iv) keeping your cool; (v) playing to your strengths; and (vi) appreciating your team. The six online YPTSS modules include a combination of short videos, written information, and a number of open-ended response questions which encourage the participant to reflect and apply the strategies discussed to their own life. Following the YPTSS workshop, it is anticipated that the participants will complete the six online modules before the following Help Out a Mate (HOAM) workshop (discussed below), however, completing the six online modules for YPTSS is optional, and not a requirement to take part in the HOAM workshop. 2. Help Out a Mate: Adolescents will be invited to take part in a brief team-based, face-to-face mental health literacy workshop. The HOAM workshop will usually be delivered after a routine scheduled practice and takes approximately 45 minutes. Workshops will be delivered in a changing room or clubhouse of the participating club, or if not available, a central location (e.g., University of Wollongong). Specifically, the workshop involves the following components; (i) what is mental health and mental illness; (ii) myths about mental illness; (iii) what is depression?; (iv) what is anxiety?; (v) how to help; and, (vi) where to get information. The workshop focuses on helping adolescents to recognise the signs of depression and anxiety, approach a friend confidently, encouraging help-seeking, make an adult aware of potential mental health problems, and understand self-help behaviours. Additionally, this workshop addresses the issue of how to ask for help if an adolescent feels that he needs it, specifically through the use of role-plays scenarios for participants to practice providing and asking for help. Additional resources provided to adolescents include a business card that lists key steps on how to help a friend [Ask, Listen, Encourage, Check Back In), and a boot bag to hold sports shoes and drink bottle with Ahead of the Game branding. All workshops will be delivered by a member of the research team with Mental Health First Aid training and previous training in the delivery of the HOAM workshop. Parents will be exposed to: 3. Number 1 Supporter: The parents of the adolescent males will be exposed to the Number 1 Supporter workshop, which is designed to increase parent mental health literacy regarding adolescent mental health via a one-hour, face-to-face workshop. Specifically, the workshop aims to raise parents‘ awareness of their role in promoting and supporting positive adolescent mental health, and to increase knowledge of common adolescent mental health disorders, positive mental health-promoting behaviours, and help-seeking options. This workshop also aims to reduce stigma, promote constructive communication about mental health, and increase parental confidence to support adolescent mental health. The parent component is also delivered at a team level, but can also be delivered at a club level (i.e., parents from multiple teams in each club attending the same session). All workshops will be delivered by a member of the research team (with Mental Health First Aid training) at the sports club where facilities allow us to do so, or at a central location (e.g., University of Wollongong). A pamphlet is also provided to parents during the workshop that summarises the workshop content. The workshop content is guided by the mental health literacy framework and is designed to be engaging through a mix of parent reflection, discussion, presentation, and videos. Materials were developed and adapted from Mental Health First Aid guidelines or used with permission from mental health organisations and parenting organisations (e.g., ReachOut, Raising Children Network). The content of the intervention workshop has been assessed for relevance and accuracy by a Mental Health First Aid trainer. The workshop is kept intentionally brief to combat parents’ reported time constraints and capitalises on the close social support networks among parents in the youth sport club environment. The information presented is set at an introductory, and specifically, the content includes: Awareness raising of the role of parents in adolescent mental health; how to recognise the signs of a mental health problem and how to tell the difference from normal teenage behaviour; professional help-seeking options; skills to start a conversation; positive preventative behaviours for adolescent mental health. Coaches will be exposed to: 4. Got Your Back: Coaches of male adolescents will be exposed to the Got Your Back workshop, which is designed to increase coach mental health literacy regarding adolescent mental health via a 75 minute, face-to-face workshop. The workshop content focuses on: (i) what is mental health?; (ii) myths about mental health and mental illness; (iii) what is anxiety?; (iv) what is depression?; (v) how to help an athlete; and (vi) creating an environment to promote mental health. In exploring this content, this workshop aims to discuss coaches‘ perceptions of their role in promoting and supporting positive adolescent mental health, to increase knowledge of common adolescent mental health disorders, positive mental health-promoting behaviours, and help-seeking options. This workshop also aims to reduce stigma, promote constructive communication about mental health, and increase coaches’ confidence to support adolescent mental health. Given a wide variation in coaches’ perceptions of their role in adolescent mental health, the workshop takes a discussion-based approach. The coach component can be delivered at a team level, but our preference is to deliver at a club level due to low numbers of coaches within a single team (i.e., coaches from multiple teams in each club attending the same session). All workshops will be delivered by a member of the research team [as above, with Mental Health First Aid training] at the sports club where facilities allow us to do so, or at a central location (e.g., University of Wollongong). All programs (parents, coaches, adolescents) will be presented following adolescent baseline data collection. Regarding adolescents, YPTSS will always be presented before HOAM. Ideally, HOAM will take place 1 week after YPTSS, although this may take up to 4 weeks depending on the individual team’s availability. The parents and coach programs will take place in parallel with these adolescent programs, although the specifics of when each of these programs takes place (i.e., same time as YPTSS session, in between YPTSS and HOAM etc.) will depend on the club and their resources. We estimate all programs will be delivered between 2 and 6 weeks following adolescent baseline. In addition to the above workshops, all participating clubs will receive promotional banners and posters which can be displayed at their clubhouse, changing rooms, and surrounding areas. These materials will be distributed after baseline data collection. The banners and posters provide brief messages to promote mental health literacy and help-seeking, in a manner consistent with the Ahead of the Game branding and workshop materials. For example, banners specify steps for improving mental fitness (e.g., keeping active, taking time to relax, eating healthily) and steps for helping out your teammates (Ask how your mates are doing, listen to what they say, explore the options they might have, and keep in touch with where they’re at). Further, following baseline data collection, adolescent participants will receive a drink bottle and boot bag to hold sports shoes/equipment with Ahead of the Game branding. All participants will be drawn from organised sporting clubs in the Illawarra, South Coast and Greater Sydney regions of New South Wales, Australia. The fidelity of the program delivery is measured via checklists which are completed by each presenter following each workshop. Further, workshop participants are asked to rate the facilitation of the workshop. Fidelity to the protocol of online components for the adolescent resilience program are monitored by completion of the modules online or via the Ahead of the Game app. Parental, coach, and adolescent attendance at workshops is monitored by the facilitator.