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What is Team ENHANCE?
Team ENHANCE is a program for student-athletes that was developed by the Women's Athletic Department of the University of Tennessee-Knoxville to create a healthy culture in which student-athletes can thrive. The name of the program is an acronym for Enhancing Nutrition, Health, Athletic performance, Networking, Community, and Education. The program provides nutrition information and education about eating disorders and other mental/emotional health issues facing young women today. It also provides support groups; intervention; individual and family therapy; outpatient treatment; aftercare services; and referral to inpatient treatment when necessary.
Team ENHANCE provides a full continuum of services to promote the well-being of the student-athlete. Student-athlete's participation is held in strict confidentiality. Participants benefit from the program's successful partnering relationships with experts in many fields - eating disorders specialists, mental health and addiction professionals, nutritionists, therapists, consultants, and authors.
Why was Team ENHANCE created?
Many nationally competitive athletic departments throughout the country are recognizing that female student-athletes suffer from severe eating disorders and often require inpatient treatment. The students' playing careers are put on hold while they receive help for this life-threatening illness. At UTK we saw the urgent necessity for an eating disorders prevention and treatment program for female student-athletes that would meet their special needs while allowing them to continue to participate in their sport. Team ENHANCE has since grown to address the entire continuum of emotional/mental health disorders that may interfere with a student-athlete's ability to function at her highest level in all areas of her life.
Team ENHANCE members
Team ENHANCE members are a highly skilled cadre, with the appropriate credentials and experience. In addition to the director and the coordinator, the group includes an academic advisor; athletic trainers; coaches; an eating disorders/addictions specialist; exercise physiologist; individual, group and family therapists; injury support group facilitators; nutritionist; psychologists; sport sociologist; strength and conditioning coaches; and the team physician. The members meet monthly to discuss issues and new ideas and to find solutions to problems. Individual student-athletes are not discussed at these meetings.
What are the problems?
The signs and symptoms of eating disorders - fasting, inducing vomiting, compulsive exercising, and taking diuretics and laxatives - can be indicative of profound problems. The extremely dangerous and harmful disorders of anorexia, starving to be thin, and bulimia, binging and then purging, or a combination of both can lead to death. Among the characteristics of sufferers from this serious disorder are denial, secrecy and low self-esteem. Team ENHANCE also encompasses education and treatment for alcohol and substance abuse, co-dependency, growing up in an alcoholic family, and the effects of living by the rules of "Don't talk, don't trust, don't feel". Also included under the program's umbrella are mental health problems such as trauma and depression which block peak performance.
How great is the need?
The Women's Athletic Department conducted a study to determine the prevalence of eating disorders among female student-athletes at UTK. The study revealed that close to 25% engaged in disordered eating that ranged from problematic to life-threatening. In response to this startling revelation, the Department developed Team ENHANCE.
How are problems discovered?
Every student-athlete participates in an initial assessment that screens for eating disorders, alcohol and substance abuse and includes a pre-participation physical exam, drug testing and a lifestyle questionnaire. If system-trained coaches, academic advisors, certified athletic trainers or the team physician perceives that a student-athlete has a problem she will be referred to Team ENHANCE for additional assessment.
SERVICES AVAILABLE FOR ALL STUDENT-ATHLETES
Team ENHANCE provides a broad array of specialized services designed to help our student-athletes in recovering, maintaining, and improving emotional health. The program provides student-athletes with a safe, caring, and confidential environment in which to get help for personal issues. Services include psychosocial assessments, nutritional counseling, individualized conditioning programs, injury support services, individual and group therapy, a family program, contracts, and referral to inpatient treatment when appropriate.
- Assessments - A psychosocial assessment is conducted by the team ENHANCE Coordinator or the Eating Disorders/Addictions Specialist in one-on-one sessions with the student-athlete to determine the nature and magnitude of the problem. All student-athletes considered 'at risk' are referred to the team physician for a complete medical health screening. The Coordinator develops a treatment plan for the student-athlete that may involve the components listed below.
- Nutritional Counseling - Team ENHANCE believes eating right and fueling the body for performance is an important part of training and competition. This is particularly important for student-athletes who are struggling with disordered eating and are having difficulties with proper nutrition and pathogenic weight control. Although there may be varying factors contributing to poor nutrition, counseling can provide solutions for many situations.
- Individualized Conditioning Program - A student-athlete may need a modified or enhanced conditioning program to provide her with the conditioning she needs to improve her performance. The Director of Team ENHANCE and the strength and conditioning staff develop programs for individuals that are based on nutritional intake, body composition, injury status, mental and emotional health, and performance goals.
- Injury Support Services - Team ENHANCE utilizes the services of Sports Psychologists to help student-athletes who are injured. When counseling a student who is injured there are three main goals of treatment. The first goal is to speed up the recovery process so that the student-athletes can get back into sport competition earlier than if they went through rehabilitation alone. The second goal is to ensure that injured student-athletes are physically, emotionally, and psychologically ready for reentry into competition. While they are usually able to recover physically from their injury, they often recover more slowly emotionally and psychologically because they fear reinjury or not being able to perform 100%. Consequently, they may fail to perform at their pre-injury level. This is limiting and frustrating for the student-athlete, coaches, and other team members. The third goal is to help injured student-athletes confront their situation and guide them in developing coping strategies for regaining emotional control of their injury and situation.
- Therapy Group - Team ENHANCE sponsors a therapy group for "high-risk" student-athletes. A licensed clinical social worker with more than 20 years of experience in eating disorders, substance abuse, and mental health disorders facilitates the closed group that meets once a week. The student-athlete's involvement in the therapy group is confidential and at no cost to her.
- Individual Therapy - A Masters level Clinical Social Worker provides individual therapy on campus to student-athletes. Many high-risk student-athletes use individual therapy and/or group therapy, depending on their individual needs and treatment plan. The student-athlete normally signs a release of information to the Team ENHANCE Coordinator so that if a student-athlete stops going to individual therapy, the Team ENHANCE Coordinator is notified.
- Family Program - Participants in Team ENHANCE benefit significantly from the family's involvement. From the beginning of their treatment, student-athletes are encouraged to include their families in their recovery. Daughters invite their parents to come to campus to participate voluntarily in Family Day offered once a year. In the morning, the Director makes a presentation on Team ENHANCE and on the issues female student-athletes face. Small group discussions follow. In the afternoon, two licensed social workers conduct a therapy session for the parents only. This is followed by a second group with parents and daughters together. Parents are encouraged to seek out local support groups in their own communities, to read books from a list given to them, and to communicate with and support their daughters throughout their recovery process. They leave campus with an appreciation of Team ENHANCE and a greater understanding of the importance of their role in their daughter's recovery.
- Contracts - A contract establishes the criteria set forth for a student-athlete's individual referral treatment plan and outlines the consequences if she fails to fulfill the terms of the agreement she made with members of Team ENHANCE. The contract can be a general contract used for many student-athletes or can be made to fit the individual.
- Inpatient Treatment - Team ENHANCE helps the student-athlete find the right treatment center, supports her throughout her stay, and works with the center to develop appropriate conditioning workouts. Upon her return, Team ENHANCE works with the treatment center on aftercare support that may include therapy, ongoing assessments, nutritional and meal plan support, a 12-step program, monitoring, encouragement, and fitness and maintenance workouts to eliminate compulsive exercise. The student-athlete attends "return to sport meetings" with the coaching staff, the Specialist, and the Director that increase mutual awareness of what she has gone through and is going through.
- Psycho-educational/Special needs Program - The Special Needs Program is a comprehensive academic support program for student-athletes with disabilities diagnosed and documented by a psychologist, physician, audiologist, or learning specialist. Among the services provided are screening tests; tutoring; help with registration, time management, study skills, and problem-solving; advocacy for course waivers, oral exams, extra time, readers and note takers; special equipment and materials such as voice-activated computers, audio recorders, books on tape, and flash cards; and community education seminars. Services are free. The program's staff includes a director, a coordinator, a graduate assistant, tutors and note takers.
A student-athlete may be referred to the Special Needs Program for a variety of reasons. She may lack study skills and find it difficult to pay attention to instructors or coaches or to recall classroom material or coaching instruction. She may be experiencing test anxiety. If an undiagnosed learning disability is suspected, the educational psychologist administers the appropriate tests. If the student-athlete does have a learning disability, she is referred to the University Disability Services Center for a complete psycho-educational evaluation. If the problem seems psychological, she is referred to the University Student Counseling Center for a computerized assessment by a clinical psychologist. These services are free. Once the appropriate diagnosis is made, the student-athlete enters the Special Needs Program and works one-on-one with the learning specialists and receives all accommodations appropriate to her disability.
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