Call It an “Evolution”: Promoting Student-Athlete Well-Being During the Transition From Collegiate Sport

The transition out of competitive sport can represent a sensitive phase in the career of any athlete. During this phase, student-athletes may encounter various physical and mental health challenges while concurrently navigating a substantial shift in their personal identities.^21,22  For the purposes of this brief review, we begin by outlining foundational work describing the various stages of sport transition and the associated experiences of athletes as they progress through transition stages. Thereafter, subsequent evolutions in this line of research are characterized, with emphasis on research that has explored the relationship between transition processes and former student-athlete wellness as well as potential strategies for promoting adaptive sport transition.

Frameworks that describe the temporality of athletic transitions can facilitate effective communication about the transition process among relevant stakeholders and can be helpful in identifying the most meaningful and influential points of intervention for guiding positive transition experiences. The literature on this topic points to a phase-like structure of the transition process,²³  as opposed to an acute-event model, and indicates that student-athletes’ perceptions of the process as well as planning for the transition may have downstream effects on health and wellness posttransition. For example, Reints²⁴  proposed a 4-stage transition model: planning for athletic retirement, career termination, start of the postathletic career, and reintegration into society. Similarly, Park et al²⁵  outlined a 5-stage model based on the transtheoretical model for behavior change, encompassing precontemplation, contemplation, preparation, moratorium, and action phases. Though postcareer adjustment varies among individuals,^23,24  perceived adjustment to athletic transition generally improves with passing time and progression through transition stages. Moreover, stage-specific factors surrounding sport discontinuation and the student-athlete’s perceived effect of these factors can greatly influence the reported quality of the transition. Specifically, perceived autonomy regarding career choices along with prediscontinuation planning appears to have a considerable effect on transition experiences.^23,26–28 

Given the sensitive nature of the athletic transition process, it is reasonable that student-athletes’ experiences during this process can influence their health and wellness post–sport exit. For example, involuntary discontinuation (eg, career-ending injury)²⁶  can adversely affect transition outcomes. In particular, recent research²⁶  among former American football athletes indicated that involuntary discontinuation was associated with more severe depressive and anxiety symptoms; having no transition plan before discontinuation was also associated with maladaptive mental health outcomes. With respect to strategic priorities for guiding athletic transition, transferable competencies (eg, communication and management skills, emotional awareness) may be facilitators of successful postcareer adaptation.^29,30  Similarly, our research showed that former women’s soccer student-athletes viewed social support and the provision of mental, nutritional, and physical health resources as catalysts for successful postcareer transition.³¹ 

Early research on the topic of guiding athletic transition revealed positive outcomes associated with programs designed to support athletes during this process. For instance, Lavallee³²  reported improved situational adaptivity, personal characteristics of self, coping strategies, and social support in male professional soccer players who engaged in a life-development intervention. However, empirical evidence is lacking to validate interventions designed to assist with student-athlete career transition. Leaning on the phaselike structure of the transition process to inform meaningful points of intervention, recent scholars have strived to advance the development and evaluation of evidence-based programs designed to assist student-athletes in the transition process, with emphasis placed on physical and mental health domains.

Our team^33,34,36  has demonstrated promising findings from a theory-driven transition program aimed at improving health-promoting behaviors such as lifetime physical activity and healthy eating in student-athletes as they transitioned out of collegiate sport. For example, through interactive discussions and activities, adaptive skills including identity exploration, setting goals that align with personal values, and engaging with peers who had shared experiences were fostered. These elements were viewed by program participants as especially beneficial to increasing their awareness of transitional challenges and enhancing their transition experience. As research into various programming evolves, it will be prudent for investigators to conceptualize methods for adapting promising elements of such programs to the needs of various student-athlete populations and to document the long-term effects of specific intervention strategies.

Collectively, previous authors aimed to appraise the process of athletic transition and conceptualize strategies for guiding successful transition from sport. Although some have examined health status post–sport exit, the dynamics of health and wellness through various stages of transition and retirement remain relatively understudied. As such, the complex interplay among transition experiences and physical and mental health after athletic transition requires continued attention and exploration.

Multiple theoretical and conceptual perspectives provide a heuristic and testable overview of the athlete transition process, such as the Taylor and Ogilvie³⁷  model as well as subsequent critiques and extensions, such as the work of Wylleman and Reints³⁸  and Stambulova et al.²³  All of these models highlight mental health as salient to athlete transition. Notably, Taylor and Ogilvie³⁷  described mental health concerns as signs of poor postcareer adjustment; however, this model offers opportunities to discuss the breadth of physical and mental health experiences throughout the athlete transition process, including both potentially positive (ie, adaptive adjustment, resilience, well-being) and maladaptive (eg, depression, anxiety, identity concerns, physical health challenges) experiences. Subsequent and more contemporary conceptualizations²³  highlight that transition outcomes are not binary (ie, adaptive versus maladaptive) and that all athlete transition outcomes, including mental and physical health, vary across the transition window as well as within a much broader range of experiences.¹⁸  For example, Keyes³⁹  discussed mental health outcomes as residing on a continuum ranging from (1) poor or maladaptive mental health (ie, marked distress, serious impairment) to (2) emotional problems or concerns (ie, ranging from moderate distress affecting functioning to mild distress involving temporary impairment) to (3) good or adaptive mental health (ie, well-being, thriving, resilience). Poor or maladaptive mental health involves an experience that is chronic and results in impaired functioning in significant areas of the individual’s life. Emotional problems or concerns include a similar constellation of symptoms occurring either more often than not or only generally or minimally affecting one’s life. Finally, good or adaptive mental health is characterized by normal fluctuations in mood and positive psychological outcomes such as thriving and resilience. This continuum is especially relevant in sport, where student-athletes, coaches, and friends and family members may misperceive that mental health is binary (poor and maladaptive or good and adaptive mental health) and poor mental health signifies a lack of “mental toughness.”⁴⁰  Such a misconception can be problematic for student-athletes’ mental health disclosure and help seeking⁴¹  in times of need, such as transition from sport.

Ultimately, existing athlete transition theories provide an appropriate basis from which to begin to understand holistic well-being during the transition from sport but are limited by a rather cursory description of the types of outcomes experienced. Such theoretical and empirical deficits could be addressed via a focus on the integration of theories to understand and address student-athlete mental health and overall well-being. The current lack of nuance in the range of mental and physical health experiences noted by extant theory for student-athletes during the transition from sport limits researchers and clinicians from designing the most useful studies and clinical transition programming to address this potential variance in outcomes as student-athletes prepare to, and eventually do, leave sport.

Other individual and environmental factors also merit further development within existing conceptual models to allow us to best understand this range of experiences. Specifically, changes in and challenges to athletic identity during the transition process can contribute to the range in mental and physical health status observed in former athletes and the interplay between these. Athletic identity has been defined as “the degree to which an individual identifies with the athlete role.”⁴²  Athletic identity is associated with mental health outcomes including depression and burnout, as well as other health-related behaviors such as physical activity.^43–45  Ultimately, sports medicine professionals who are educated on the identity-related aspects of transition will be better positioned to promote adaptive outcomes during transition by encouraging and reinforcing student-athletes in cultivating broader self-perceptions and self-worth not rooted solely in athletic performance.

As noted earlier, additional factors relevant to the transition process are social support, autonomy in the discontinuation or transition decision-making process, and pretransition planning. Social support from others (eg, teammates, athletic staff, family, friends) has been shown to be important to mental health across the transition period.^31,46–48  Though not always feasible because of the environmental constraints of sport participation (eg, being cut from the team, exhausting eligibility, career-ending injury), having some autonomy in the decision-making process relative to sport transition was adaptive for mental health outcomes in some former athlete populations²⁶  and is relevant for continued work in this area. Finally, as noted in the literature,³⁷  with the support of programming and resources provided by their institution, student-athletes would benefit from engaging in specific planning efforts before they transition from sport.²⁶  All of these factors should be considered in athlete transition theory, research, and practice going forward.

Guided by continued conceptual and theoretical development, a variety of study designs and data-analytic procedures would be beneficial to further our understanding of student-athlete health and well-being during transition from sport. First, longitudinal study designs ranging from large quantitative cohort studies to multi–time-point case studies are well suited to gathering the data necessary to examine the breadth of student-athlete experiences across the sport transition and advance the understanding of student-athletes’ long-term mental and physical health. Moreover, mixed-method and qualitative designs can help with describing the nuances of student-athletes’ lived experiences across the breadth of the transition experience.

Despite the important knowledge generated to date, the current research and practice related to athlete transition have been limited by an underdeveloped understanding of individual and environmental factors that affect a range of outcomes relevant to holistic well-being. Theoretical integration is necessary to synthesize and test hypotheses best suited to enhancing the knowledge base surrounding this important life stage. Work on athlete transition is also largely segmented into a series of predictors (eg, social factors, identity, personal and environmental factors). Knowledge development in this area would proceed at a faster rate with a more holistic set of factors integrated within the same study designs and, ultimately, would enhance applied programming efforts. Finally, longitudinally oriented research methods and associated data-analytic techniques are needed to answer the complex and theoretically informed research questions that will provide the knowledge necessary to change population-level health in former student-athletes. Ultimately, to answer the important questions and address the challenges, multidisciplinary research efforts are often needed. The athlete transition space is no exception, and, going forward, the creation of multidisciplinary research teams will be essential to develop projects that are both meaningful to the target population and attractive to extramural funding agencies that can fuel the resources needed to accomplish these research efforts.

Based on our brief review of the literature outlined in this paper, we offer the following recommendations (Table and Figure) for professionals providing care to student-athletes (eg, athletic trainers, team physicians, sport psychologists) in developing future research, policies, and programs to support student-athletes’ holistic health and well-being as they transition out of sport. Although these recommendations are offered in the context of our focus primarily on collegiate student-athletes, they are likely transferrable to other athlete transition contexts such as the transition out of competitive high school, Olympic and international, and professional sports.

Leaving a competitive sport career is a complex transition that can reflect a wide continuum of experiences for student-athletes¹⁹  and should be conceptualized as such in sports medicine research and practice. For most student-athletes, this transition also occurs during the developmentally impactful period of emerging adulthood.⁴⁹  Research relative to athlete transition has important implications for sports medicine practitioners who strive to enact a holistic approach to health care. Sports medicine professionals are a critical part of the organizational structure that supports student-athletes; however, a more robust understanding of the role of athletic trainers and other sports medicine professionals in supporting a positive transition out of competitive sport is warranted. Ultimately, former athletes and those currently in transition can benefit from targeted, evidence-based sports medicine resources to manage and promote lifespan health. We hope the research reviewed herein and our proposed recommendations spark continued efforts to better understand and support student-athletes’ well-being as they evolve through their next stage in life.