Objective: To synthesize the best available evidence regarding the perceptions and current clinical practices of athletic trainers (ATs) in integrating psychological skills into patient management.
Data sources: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) (via EBSCOhost), PsycInfo (via EBSCOhost), SPORTDiscus (via EBSCOhost), Scopus (via Elsevier).
Study selection: Studies had to investigate the current clinical practices and perceptions of certified ATs in integrating psychologically informed practice for patient management. Studies that were Level 4 evidence or higher were included. Studies were excluded if they were published before 1999, the primary language was not English, they involved athletic training students or other rehabilitation specialists, or if the studies explored the athlete and/or patient's perception of psychosocial techniques or strategies.
Data extraction: This systematic review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Statement in Exercise, Rehabilitation, Sport medicine and SporTs science (PERSiST) guidance.
Data synthesis: A total of 1,857 articles were reviewed, and 8 met inclusion criteria. Two studies had level 2a evidence, four studies had level 4a evidence, and two studies had level 4b evidence. Six studies were rated as good quality, and two studies were rated as lesser quality. The included studies demonstrated a high-quality body of evidence with consistent results which strengthens the review findings.
Conclusions: Ats have the knowledge to identify when athletes are psychologically affected by injury and can identify common psychological responses. Although Ats acknowledge the value of implementing psychosocial strategies, lack of confidence in implementing basic or advanced techniques, feeling underprepared by their educational program, and lack of clinical training appear to impact the use of psychosocial techniques in clinical practice and the rate of mental health recognition and referral amongst ATs.