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“I didn’t feel the clock was appropriate during the season as it added stress to the student-athletes watching the countdown,” she continues. “We’d turn off the clock on a Thursday; but now, in the offseason, I believe it has great purpose because it helps me to focus and not get too lackadaisical in my thought process.” This comes from a person whose working week is approximately 70 hours – an even more remarkable fact give that she has also just finished the second semester of her doctorate.
This picture offers a snapshot of the sports medicine department of an Alabama Crimson Tide football program that has, under Head Coach Nick Saban, won five national championships in the past decade. There is the restlessness that characterizes serial winners but Alabama’s approach is far from cold-blooded when it comes to its student-athletes, as Gilmore-Childress explains: “For the first time, they are leaving their families or whatever dynamic they come from to come here and so we are their new family. Our Athletic Director, Greg Byrne, has placed a strong emphasis on mental wellbeing and, if you’re not strong mentally, then you’re not going to have that sharp edge on the field or in the classroom either.
“I must also mention that we have the full support from our Director of Sports Medicine, Jeff Allen. We want to be at the forefront; winning games is great and we have a track record of doing that, but we’re more concerned with the health and wellbeing of the student-athlete. When that is your focus, the winning comes naturally as a side-effect.” The Leaders Performance Institute takes a look at five areas where Alabama is taking a lead in mental wellbeing.
“Coach Saban’s door is always open for all of his staff and athletes,” says Gilmore-Childress. “When you follow his example, you cut back on the stigma and the resistance towards conversations or having some form of help when a particular situation calls for it.” The veteran head coach is the most successful in Alabama history, a status that has been honored by a bronze statue on the Walk of Champions that leads to the Crimson Tide’s Bryant-Denny Stadium in Tuscaloosa. Few understand the demands on student-athletes so acutely, as well as the process of continually rebuilding a roster that has enjoyed ten consecutive NFL Draft first round picks. It is a constant cycle of regeneration, with freshmen joining every season and seniors taking the next step in their lives, be it in the NFL or beyond.
Within this context one can understand the desire for the countdown clock. “We no longer call it the offseason because there’s always something going on,” Gilmore-Childress observes, “but I get the total support from Coach Saban, who sets the tone for that and he requires that all staff have an understanding of what I’d call ‘red flags’, from the bottom to the top. If you hear the term ‘red flag’ then there’s an awareness that you need to discuss that with Coach Saban or maybe Scott Cochran, our Head Strength & Conditioning Coach, or with the medical staff. We don’t let an athlete flounder or struggle when we know we can provide assistance. I also get the total support of Greg Byrne, and when that support comes from the top, from both sides, that opens the door for student-athletes to come forward.”
For all that, there is inevitably still reluctance on the part of some, whether for social or cultural reasons, and the solution often comes in the form of a chat. “If you can just have a conversation with that reluctant person then that generally takes care of any hesitancy to come forward and seek help.” Additionally, their peers have an important role to play: “We’ll have student-athletes from all sports come forward and say my teammate suggested that I come and talk to you. I think there’s a lot of positive reinforcement in that, so if it’s working for some athletes then they’re going to spread the word.” Byrne was also instrumental in promoting the use of mental performance apps on a volunteer basis. “One app uses cognitive behavioral therapy and mindfulness,” says Gilmore-Childress. “So there’s lots of open doors and lots of support through medically sound ideas.”
2. An athletic trainer with expertise in behavioral medicine
Gilmore-Childress, who has worked at Alabama for 22 years in various positions, is one of a growing number of behavioral medicine experts cropping up in college sport. Her work covers all varsity sports but she also serves as an athletic trainer with the football team. Other schools have been taking note: “Several are modelling their program on ours and there are some cornerstone programs in college athletics that have someone with my title or something similar, and that’s a dual role with behavioral medicine with athletic training.” Once again, it was Coach Saban who blazed a trail in combining these roles. “He introduced that concept during his time at Michigan State and LSU before bringing it to Alabama. The idea is to have an athletic trainer in charge of the behavioral medicine aspects of athlete development because the athletic trainer is able to attend all practices, games and treatments and they have the ability to care for the athlete physically, which can open the door for conversations to help them with any issue that they may be going through mentally or physically.”
3. A continuous search for red flags
Gilmore-Childress is quick to defer to the work being done by Coaches Saban and Cochran (“they’re the ones who continue to keep our heads above water”) as well as Director of Medicine Jeff Allen, but her work in looking for red flags is essential. “Initially, you’re just doing a combination of a mental health and athletic training assessment,” she continues in explanation. “I look at the athlete, do a glance-over, and ask myself do they look clean? Are they wearing the same thing they’ve worn for several days? Are their clothes clean? So they look showered? Are they awake and alert? Do they seem distressed or are they paying attention? Then, during practice, are they listening to their coach? Are they following instructions? Are they allowing themselves to be coached? In between plays, what type of conversations are they having with their peers when they’re not on the field? Are they asking me questions?
“So it’s an overall observation and you can come away with different bits of information about how they’re doing. It’s not as if you’re a secret spy, it’s just to make sure they’re OK. If it’s someone you know well then you’re able to identify them by their gait, if they’re in a crowd of people, then you’ll certainly be able to identify if they’re struggling with someone or something. I think athletic trainers have that niche because they’re so focused on the physical aspect that they readily pick up on the mental aspect as well. Being on the practice field enables you to say, hey, is everything going OK? You’re not going to have that detailed conversation yet but at least you can express that you’re concerned because they’re not having a great day. That can lead to coming to a conclusion that there’s something big going on that nobody knew about.”
4. A willingness to bring in people from the outside
For student-athletes to be completely open in their counselling sessions, they must know that their therapist does not have a direct line to the coach. Consequently, Gilmore-Childress is the only full-time Alabama employee working in behavioral medicine at the school’s athletic department. “My ten staff are outsourced,” she explains. “They’re not technically employed full-time by the University of Alabama, but at this point we have seven counsellors and, within those seven, we have an addiction specialist, in addition we have a primary sports psychologist, and two psychiatrists and then we reach out to a group of other sports psychologist as preferred by sport. They all have their own businesses as well but they’re very unselfish; all these individuals give us the support we need and it may mean they’re not making as much money as they would if they stayed all day at their clinics or healthcare facilities. Instead, they have two days cut out for me and we will schedule athletes throughout the course of the day. Six days a week we have resources for student-athletes to meet with therapists, physicians and clinicians.”
Athletic Director Byrne will also arrange educational talks for student-athletes through Student Athlete Enhancement, which include an array of guest speakers, and Gilmore-Childress recalls a visit from former WNBA star Chamique Holdsclaw, who spoke to all varsity athletes. “They see someone who is a superstar in the athletic world speak about their vulnerability with their mental health.
5. An integrated approach
When we ask about the school’s major successes as a behavioral medicine department, Gilmore-Childress is quick to mention the general awareness of mental health within the wider academic administration. “They understand the need for full health resources for their students and this has grown over the last ten years to the point where our vocabulary is the same and there’s a working knowledge that our student-athletes may need to see someone for their mental wellness issue.” It is born from their fully integrated approach. “The academic aspect is tightly linked in with the athletic aspect and we communicate with the academic department daily; we meet weekly and we are on the phone daily so that nothing gets passed over about the student-athletes.”