Using Acceptance and Commitment Therapy for Unhelpful Thinking Toward Body Image With an Elite Figure Skater

We outline the sport psychology service delivery provided to a 23-year-old elite figure skater who reported unhelpful thoughts about her body image that hindered her performance and concentration in training. An acceptance and commitment therapy intervention was implemented over 12 sessions across a 6-month period. The acceptance and commitment therapy matrix was used to conceptualize the client’s “stuckness” and provide a foundation for the techniques implemented. The aim of our work was to increase psychological flexibility, helping the client sit with, rather than change or remove, her unhelpful thoughts, moving her toward the athlete she wanted to be. This case reports how psychological flexibility was achieved through exercises to help the client “unhook” from her unhelpful thoughts about body image. Reflections from the client were obtained to monitor and evaluate the service delivery process. The trainee’s reflections on practice highlight the unpredictability of presenting problems disclosed during service delivery, the isolating and challenging nature of working with elite athletes in private practice, and the need for practitioners to understand the theoretical orientations of their approach.