Medical professionals play a role in prevention of abuse, harassment and bullying in sport

Sport and exercise medicine professionals have an important responsibility to protect the athletes under their care against abuse, harassment, and bullying, according to a position paper published in the September issue of Clinical Journal of Sport Medicine. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The position paper by The Canadian Academy of Sport and Exercise Medicine (CASEM) provides sport medicine physicians and other professionals with guidance on dealing with reported or suspected abuse, harassment, or bullying of athletes. "It is essential that sport medicine specialists be educated on issues of abuse, harassment, and bullying in sport, and be equipped with strategies to intervene if or when potential cases arise," according to the new statement. The lead author was Ashley E. Stirling, M.Sc., of University of Toronto. The position paper and accompanying discussion are also accessible online via the CJSM website: see www.cjsportmed.com .

Athletes Are Vulnerable to Abuse, Harassment, and Bullying

The position paper was prompted by a series of reported incidents of abuse, harassment, and bullying in Canadian sport. Those events—including several high-profile incidents of sexual misconduct and hazing of athletes by coaches—highlight athletes' vulnerability to abuse and others kinds of maltreatment.

By issuing the paper, CASEM seeks to provide sport and exercise medicine professionals with knowledge to help them identify abuse, harassment, and bullying in athletes; to respond appropriately to reported or suspected abuse; and to work toward preventing abuse from occurring. Abuse includes physical, sexual, and emotional abuse, along with neglect. Harassment is defined as "unwanted or coerced behaviours" by a person in a position of authority, while bullying refers to potentially harmful "physical, verbal, or psychological behaviours between peers."

The "unbalanced power dynamic" between coaches and athletes is a key risk factor for abuse. Vulnerability to sexual abuse appears highest during peak athletic maturation, when athletes have the most at stake in terms of their careers. Parents often trust coaches uncritically, which may increase vulnerability. The culture of sport itself may be a risk factor for abuse, with athletes sometimes describing sexual exploitation as "part of the game."

Abuse, harassment, and bullying may have many long-term negative consequences, such as psychological and emotional problems, physical self-abuse, eating disorders, and substance abuse. The paper provides examples of abuse, harassment, and bullying in sport, along with signs and symptoms of possible abuse in athletes.

Recommendations for Intervention and Prevention

"Medical professionals play an integral role in the prevention and intervention of abuse, harassment and bullying in sport," the authors write. They present recommendations for sport and exercise medicine specialists dealing with reported or suspected abuse of athletes, including the need to report cases of abuse to the appropriate authorities. Depending on the situation, that may mean child protection services, law enforcement, or sport governing bodies.

Recommendations for preventing abuse, harassment, and bullying of athletes include "an extended responsibility to educate individuals in leadership positions on their position of trust/power and their need to assure the long-term well-being of the individuals within their care." The position paper also includes recommendations for protecting against unwarranted allegations of abuse—starting with respecting professional boundaries involved with the physician-athlete relationship.

"Clinical Journal of Sport Medicine is committed to publishing thought-leading work, such as position statements from our official member societies," comments Editor-in-Chief Willem Meeuwisse, M.D., Ph.D., of University of Calgary.