'Necessary Roughness' plays fast and loose with therapy

The Unreal World

'Necessary Roughness'

10 p.m. June 29, USA Network

Episode: "Pilot"

The premise

Dr. Dani Santino (Callie Thorne) is a Long Island psychotherapist who specializes in behavioral management, hypnotherapy, smoking cessation and weight loss programs. When she discovers that her husband is cheating on her, she kicks him out and starts looking for ways to augment her income to support her two children and pay for her divorce proceedings. After she meets Matthew Donnally (Marc Blucas), a trainer for a fictitious professional football team called the Hawks, Dani begins working as the team's therapist. The players are "playoff caliber," Matthew tells her, but they commit many mental mistakes on the field. Dani focuses on wide receiver Terrence "TK" King (Mehcad Brooks), whose anger management problem causes him to express himself in detrimental ways. TK has a violent temper, a criminal record and is on a self-destructive path that includes all-night booze-fests just 72 hours before game time. Dani helps TK overcome his personal demons and build his self-esteem by teaching him that forgiveness treats anger. "No one defines our worth unless we let them," she tells him. When the coach demands to know what's being said in the therapy sessions, Dani refuses, citing patient privacy. But her therapy is successful, and in the next game, TK catches a touchdown pass.

The medical questions

What is the role of a sports psychologist, and can she help players perform better? Could someone with Dani's background be hired by a professional team without special training in sports psychology? Do many athletes have anger management and deep-seated emotional problems that interfere with performance? Does a coach have a right to learn details of a player's therapy, or is this off-limits?

The reality

The focus of sports psychology is to "get quick results to improve an athlete's performance," says sports performance consultant Loren Fogelman, who is based in Ashland, Ore. She believes time is of the essence and that the process involves "digging down deep to understand core issues, thoughts and emotions that impact performance along with developing a strategy to help an athlete create a new focus."

Sadly, almost any kind of therapist with an inside connection can wind up working with top athletes, and the show accurately reflects that, says Roland A. Carlstedt, chairman of the American Board of Sport Psychology. Such therapists often advance "anecdotally based theories and claims devoid of evidence," he says. When a player catches a touchdown pass, it "supposedly attests to an intervention's efficacy, when in fact such a catch would likely have been made anyway."

Carlstedt, who practices in New York City, has researched the constellation of psychological traits and behavioral tendencies that are most likely to predict a player's performance. For instance, athletes who are able to block distressing thoughts from the conscious mind and get in the "zone" have the potential to overcome their self-doubts and worries, develop an intense focus and perform well. On the other hand, players who are more neurotic and can't block distressing thoughts may be overcome by fear and self-doubt that causes them to choke at a critical moment, he says. Interventions must be individualized and based on objective scientific criteria, he adds.

According to Carlstedt, the entire mission of the American Board of Sport Psychology is to counter pseudoscience like this show's portrayal of sport psychology and replace it with evidence, procedure and accountable standards. "Dramatic accounts of sudden therapeutic breakthroughs are indeed a thing of Hollywood and fiction," he says.

Fogelman says that some athletes regard anger as a motivator, but there is a fine line between using anger to give you an extra boost and having it get out of control. She believes that anger can mask underlying emotions including fear, anxiety, frustration and resentment. For some athletes, performing well under pressure can actually help them manage their anger and other negative emotions. But Carlstedt says that the way the show portrays Dani resolving TK's longstanding anger management problems in only a few days and linking that to his touchdown catch is "absurd," though in the real world, poorly trained sports psychologists make such claims all the time.

Licensed psychologists are supposed to keep their patients' issues and treatments confidential, and an athlete would have to formally consent to having his or her case discussed with a coach or anyone else, Carlstedt says. But Carlstedt is concerned that rogue practitioners often ignore these basic ethical principles in a rush to curry favor with a coach. A therapist may communicate with the coach on a "need to know" basis only if a Release of Confidentiality form is signed by the athlete or if there is an immediate concern about the athlete harming himself or others, Fogelman says.

Siegel is an associate professor of medicine at New York University Langone Medical Center. His new book is "The Inner Pulse: Unlocking the Secret Code of Sickness and Health."


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