Dallas Cowboys’ quarterback Dak Prescott has faced adversity on and off the field. Yet, when recently asked how he was coping with disappointment following a very public broken engagement, his response emphasized faith, fatherhood, gratitude, and perspective (NBC DFW et al., 2026). His response underscores an essential reminder for psychologists: professional athletes do not function in isolation.
Psychological care for athletes has traditionally emphasized performance enhancement, injury recovery, and mental well-being. Similarly, multicultural competence has appropriately focused on demographics such as ethnicity, gender, and physical ability. Although these factors are essential, they do not fully account for the broader systems that influence athletes’ relationships, psychological functioning, and overall well-being. A more holistic clinical framework recognizes that athletes’ mental health, wellness, and performance are shaped by the complex intersectionality of identity, family systems, and spirituality.
This perspective guided my presentation at the 2026 NFLPA Clinician Conference, where I encouraged clinicians to expand case conceptualization beyond the individual athlete to include the relational systems and spiritual influences that shape their lives.
HERE’S WHY:
Professional athletes often experience role strain and role conflict as they juggle multiple identities (e.g. performer, provider, partner, public figure). Meanwhile, their partners and spouses frequently carry the invisible weight of isolation and labor from lifestyle demands such as frequent relocation, parenting, household management, extended family expectations, and public visibility (Waligorska et al., 2024; Blount, et al., 2024; Blount, et al., 2026).
Family systems, however, represent only one piece of the broader context of an athlete’s life. Research consistently highlights the value and positive impact of religion and spirituality on athlete identity formation, emotion regulation, confidence, and meaning-making (Noh & Shadan, 2020; Shirvani, et al., 2025). Faith practices, particularly prayer and meditation, are widely embedded in athletic culture (Noh & Shahdan, 2020), and many players frequently use their platforms to openly share their faith (Associated Press, 2024).
More importantly, for many athletes, spirituality and religion are not compartmentalized, they are interwoven into their identity, relationships, and coping.
Despite its importance to many athletes and patients’ interest in addressing it in therapy, psychologists often report limited training and confidence in ethically integrating spirituality into clinical practice (Abrams, 2023; Vieten, et al., 2023).
The following clinical considerations may support psychologists in providing comprehensive care to professional athletes and their families.
CLINICAL CONSIDERATION #1
Treat the Family System, Not Just the Athlete
- Professional athletes occupy many roles (e.g. player, provider, partner, parent, public figure), each carrying distinct responsibilities and competing demands that contribute to individual and relational distress.
- Longstanding family dynamics may compound these pressures and follow athletes into adulthood. For example, individuals who experienced parentification tend to carry a sense of over-responsibility, which in professional sports can manifest as financially supporting family members, mediating conflict, or responding to repeated requests for perks, access, or endorsements (Akhavan et al., 2020). These ingrained patterns of obligation may contribute to depression, anxiety, career concerns, guilt, over-functioning, and boundary-setting difficulties (Berkes & Piko, 2025; Dariotis et al., 2023).
Exploring family dynamics strengthens case conceptualization and reduces the risk of attributing presenting concerns to the athlete alone.
CLINICAL CONSIDERATION #2
Consider the Hidden Burdens of Partners/Spouses
- Spouses and partners face many of the same stressors as athletes. They often quietly manage lifestyle disruptions related to frequent travel, unexpected relocations, and increased parenting labor during the season. Further, the financial power imbalance can leave partners feeling defeated when navigating blended and extended family demands.
- Athletes’ demanding and unpredictable schedules during the performance season can reduce couple quality time and heighten concerns about perceived or actual infidelity. For some partners, this relational strain also heightens anxiety about perceived or actual infidelity. Partner’s may also experience loss of personal and professional identity, isolation, and direct or indirect public scrutiny (Blount et al., 2024; Blount, et al., 2026; Welcome & Hanley, 2026).
Understanding partners’ hidden experiences and sacrifices provides valuable insight into relational factors that influence athlete well-being, couple dynamics, and overall family functioning.
CLINICAL CONSIDERATION #3
Spirituality & Religion Shape More than Performance
- Spirituality and religion influence many aspects of athletes’ lives including identity-formation, coping, decision-making, injury recovery, meaning-making, and relationships (Noh & Shadan, 2020; Shirvani, et al., 2025). However, clinicians cannot assume that all spiritual frameworks lead to effective religious coping.
- Religious coping is how we “understand and deal with life stressors in ways related to the sacred” (Pargament, 1997) and can be positive or negative. In professional sports, examples of religious coping may include:
| Positive Religious Coping Examples | Negative Religious Coping Examples |
|---|---|
| Seeing injury recovery time as an opportunity to deepen faith. | Questioning God’s love after season-ending injury. |
| Praying for wisdom and trusting God with trade decisions. | Feeling abandoned by God after being cut or traded. |
| Seeking forgiveness after public mistakes affect the team and/or family. | Attributing a game loss to an imperfect pre-game prayer ritual. |
| Seeking spiritual counsel or praying about relationship or performance distress. | Using prayer to avoid addressing family conflict. |
Assessing the role of spirituality and religion helps psychologists discern whether faith is a source of resilience or source of distress.
CLINICAL CONSIDERATION #4
Ethically Integrate Spirituality and Religion
- Ethical integration begins with assessment, not assumption or avoidance – about the clinician or the patient. Two questions can guide conceptualization, treatment planning, and intervention:
- What do I need to know about the patient’s spirituality?
Spiritual assessment may include screening measures such as the FICA (Borneman et al., 2010) or HOPE (Sleeth et al., 2025), a spiritual genogram (Sahin, 2017), spiritual life map (Hodge, 2005), or clinical interview. These approaches clarify the presence and relevance of spirituality and religion in the athlete’s life.
Psychologists can initiate the conversation with questions like:
- Do you identify with a specific faith or religion?
- Does faith or spirituality play a role in how you’re navigating this situation?”
- How do you find hope and courage when you need it most?
- On a scale of 1 to 10, how important is it that we include your spirituality in our work together? What might that look like?
When spirituality is salient, further exploration can clarify the athlete’s view of God over time, spiritual strengths and values, religious practices (if any), and effectiveness of their spiritual coping.
- What do I need to assess about myself as the treating psychologist?
Psychologists may unintentionally base their spiritual competence on how they feel and their personal religious affiliation (or lack thereof), leading them to underestimate or overestimate their ability to ethically integrate faith into treatment. It is important to understand that spiritual competence is more than comfort level, good intentions, and personal faith. Spiritual and religious competence refers to the “necessary knowledge, attitudes, and skills which mental health professionals need to acquire to work effectively and ethically with diverse clients” (Fox et al., 2026).
- Vieten & Lukoff (2022) proposed 16 spiritual and religious competencies to support ethical integration of this critical cultural diversity factor into clinical practice. Familiarity with these domains help minimize biased, avoidant, or inadequate practice when spiritual issues are raised. Further, these domains offer guardrails along the spiritual integration continuum, preventing both spiritually avoidant care and spiritually directive care (Saunders & Miller, 2010).
- Competent practice also includes recognizing when collaboration, consultation, or referral to clergy or spiritual leaders is appropriate, even when the clinician is considered highly competent (Vieten & Lukoff, 2022). Referrals may be warranted when athletes seek theological direction (e.g. salvation or doctrine questions, moral decision-making dilemmas), when the psychologist is unsure if the patient’s spiritual beliefs are adaptive or maladaptive, or when the athlete’s questions fall outside the psychologist’s scope of practice.
Ultimately, ethical assessment of athlete’s spirituality and religion helps psychologists distinguish healthy from unhealthy spiritual coping that contributes to or exacerbates mental health concerns.
RELEVANCE TO BOARD CERTIFIED SPECIALISTS:
Board-certified psychologists across specialties are uniquely equipped to bring expertise to psychological care of professional athletes and their families. For example, Couple & Family Psychology specialists are specifically trained to incorporate systems thinking into conceptualization, assessment, and intervention. Other specialists bring advanced competencies relevant to athletes’ diverse needs in areas such as career development and life transitions, injury and rehabilitation, addiction, psychopharmacology, neuropsychology, and complex mental illness. Beyond the therapy room, specialists can also serve as consultants and educators to coaches and trainers, clergy, medical professionals, and others who regularly interact with athletes and their families. Specialists’ advanced training and experience in multicultural diversity and interdisciplinary care further equips them to address the complex emotional, relational, and spiritual systems that shape athletes’ well-being.
Prescott’s recent reflections on faith, family, and personal adversity highlight the importance of understanding the factors that shape athletes beyond the field. Athletic performance is only one part of their story. Their identities, roles, relationships, histories, and spiritual lives influence how they experience success, challenges, transitions, and emotional distress. Intentionally including spirituality and family systems in case conceptualization, assessment, and intervention strengthens culturally responsive practice. These clinical considerations extend beyond sport psychology to psychologists who treat athletes, partners, and family members across individual, couple, or family therapy.
References
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QuaVaundra Perry, PhD, ABPP
Correspondence: drqperry@gmail.com