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Teen Health/Concerned about a teen I coach


QUESTION: Hi.  I asst. coach a varsity HS sport.  I am concerned with the behavior of one of the players.  When she is not playing well, by her standards, she will start to mope, lose her drive and focus.  She will also start to scratch her thighs.  Apparently, this was a behavior seen last season.  This season it morphed from scratching her upper thigh, to scratching her neck and thigh and sometimes punching her other thigh.

I am concerned, but as an asst. coach I can not approach this subject and it seems that the other coaches feel that it is immaturity and it will pass.  Apparently the mom commented on it last season and all of the players notice it.  It brings the team down, but I am concerned for her.  Am I over reacting?

Any advice?


I really feel for the position that you're in -- it's a tough one.

Before I dig in, I have a couple of follow up questions, but don't worry if you don't know, or for privacy reasons, can't comment on explicit details:

1. Do you know anything about your player's relationship with her mom, or the general dynamic of her home life? Is she in good academic standing? Is there any reason to believe that she struggles with any food or body related issues?

2. Besides these episodes is she generally well liked and accepted by the rest of the team?

3. Is the scratching something that is done publicly or is it private and only discovered after the fact? Is it hard enough to be considered injury-causing -- for example, do the marks last several days or require a band-aid?

4. If you're comfortable saying, do you feel like the other coaches have an appropriate style of leadership and form good relationships with the girls?



---------- FOLLOW-UP ----------

QUESTION: Thanks for getting back to me so quick.  I will answer your follow ups the best I can:
1.  Her mother is tough on her.  E.g.  She had a particulary great day of play.  When I complimented her, she said "well, my mom said I am playing terrible."  After losing in states, her mom came to the coaches and said "tough loss, but X played awful."  We reminded her to just give her dtr a hug.  She doesn't seem to have food related or body image issues.
2.  She is charismatic.  People are naturally drawn to her.  She likes attention and to be the center of it.  She likes to take responsibility for the good stuff, but not the bad stuff
3.  She scratches right there in the middle of the game.  They are red enough that they can last for a few days.  Sometimes only for a few hours.
4.  When she pouts, places blame on others and isn't a good teammate, she is spoken to (she often shrugs and pulls away like a child).  But, is rarely benched for bad behavior, is immediately reinforced with more play time.  Relationships between the coaches and all the girls are good and strong.  She brings the team down.  The team goes the way her mood goes.  Coaches talk to her, give her pep talks, do the normal stuff you would do with a kid who feels sorry for herself. This has been her ongoing issue for 2+ yrs.

Sorry, J. this might be a little lengthy:

You are not over-reacting. There is something wrong here. However, the way in which you decide to react to this situation is where it gets really tricky.
So what should you do? Unfortunately this problem is bigger than you and bigger than the team and I don’t have any bulletproof answers.


1.   The side effects of abuse can manifest themselves in many ways. Physical abuse can be easier to spot than emotional or sexual abuse, but in any of these cases you have a responsibility to report it to authorities if you think it’s a possibility. If you at any time suspect that this behavior could escalate to severe self-harm or even suicide tell someone immediately.


2.   You can force the issue with the head coach and insist upon action which may have professional repercussions. you can demand that the mother be made to sit down and have a meeting with you, the head coach and preferably a third party such as a guidance counselor and you can all try to persuade her that a talk with a counselor who specializes in teens would be prudent. Even a trip to the pediatrician would be better than nothing.

3.   The girl can be confronted about her behavior directly and you can suggest that she seek help via a guidance counselor or outside therapy. Tell her you're worried about her want her to be safe, healthy and happy.

4.   You can do none of the above and hope for improvement.

Potential problems:

a)   If the mother cannot be counted on to provide absolute and unconditional love and support, she is a definitive part of the problem and cannot be trusted to be part of the solution. This means that anything that appears to question her parenting or insinuates that her daughter’s behavior is reflecting poorly on her may provoke a decidedly counter-productive reaction that may be harmful – not helpful.

b)   Intrusive measures which encroach on the girl’s sense of control are not recommended. You don’t want to isolate her, or make her feel like you’re untrustworthy. For someone who may have a limited support system, she needs as many reliable adults in her life as possible. This means that your player is going to have to be an active participant in her own treatment and honesty and transparency on your end is encouraged. Lots of meetings with teachers, parents, and coaches behind her back are going to make her feel wary and uncooperative – you don’t want this. You’re an ally not an enemy.

Bottom line:  This is someone who needs objective reassurance of her gifts, gentle feedback on her faults, and the tools to manage conflict. The best person to do this is a professionally trained therapist, but you can help and in many ways it sounds like you already are.

If you're able to seek out the guidance counselor for advice without setting off a chain-reaction, I would do that. Make sure she is set up for success, if you can engineer ways for her to look good in front of mom, even better. Let her know that you care and that she can talk to you about anything. If you’re male, obviously you’re going to have to use your best judgment to ensure that boundaries are clear, intact and appropriate. Stand up for her if you hear her mother dismissing her. Let your athlete know that she meets your expectations and that you’re proud of her abilities. Continue to be firm about your standards for acceptable behavior and stress the importance of being a good teammate; emphasize how essential her role on the team is.


Clearly this poor girl is struggling, I could speculate possibly diagnoses, but I don’t know her, so I won’t. Suffice to say, she’s obviously placing an irrational amount of pressure on herself, perhaps going so far as to equate her self-worth with her athletic performance or perfectionism in general. Any weakness or failure is unacceptable and precipitates a rush of painful anxiety. I don’t want to be hasty in pointing fingers, but your description of this girl’s mother is troubling. Several studies have concluded that children with exaggerated levels of self-criticism correlates with parents (especially same-sex) who’s parenting style is restrictive, authoritarian, punitive and controlling. Furthermore, intense parental criticism is also associated with higher incidences of self-harm.

Constant messages of rejection and reproach can erode self-esteem and replace it with insecurity and self-loathing.  While on the path to autonomy, children look to their parents to explain and define them and their role in their environment. From these descriptions they’re able to build characterizations such as, am I good? Am I worthy of praise and affection? Do I make people proud? Without a healthy sense of identity, complete with an accurate gauge of strengths, weaknesses and confidence in one’s own lovability, age-appropriate development is undermined and perception is skewed. In this case it’s plausible that the girl is using her athletic achievement to the seek recognition and approval she craves; to prove that she’s worthy of it, to prove that she’s good enough for the team, her mom, and especially herself. When this is threatened – the strain is unmanageable and the emotional tension mounts.

I believe that what you’re seeing, this scratching and hitting, is a mixture of self-soothing and sef-injurious behavior. Try to remember that she’s not doing it on purpose to bring down the team; it’s an impulse and a reaction triggered by self-perceived failure.  This is someone who has trouble regulating her emotions, resisting impulses and has no idea how to handle stress and disappointment. Scratching or hitting may indeed seem like a bizarre reaction to frustration, but you have to realize how effective it is at relieving a buildup of pressure . For someone who has virtually no strategy for control feelings of depression or stress, it’s the easiest fix. When she scratches or hits herself, the result is a flood of beta-endorphins that offers temporary relief of whatever uncomfortably intense emotions she’s experiencing. This reprieve acts as a powerful behavioral reinforcement, so powerful that it becomes ingrained as an automatic response.

Obviously this is unhealthy, but there isn’t an easy fix. Forcing cessation of the habit (through scolding or other means) may seem tempting, but it is pointless unless the destructive actions are replaced by a constructive means of channeling her negative energy. For her this means hard work, new skill acquisition and probably more help than you and the other coaches can give her.

Ideally, this girl will receive the help and possibly the medication she needs and the situation gets better. The good news is that even if you decide that the risks to your job and your relationship to your player, her mother, and your head coach prevent you from pursuing this, she may eventually seek help on her own. If she goes to college and is removed from a toxic home life and is able to utilize the school’s resources there is no reason why we can’t hope that she’ll develop a normal set of coping skills in time. Remember, that by serving as a good role model, a source of gentle support and consistent leadership, you're already making a difference in her life. She's lucky to have you. Keep up the good work.

Good luck,


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Julia Fout


I can answer questions about sex/relationships/sexual orientation, HIV/STIs, pregnancy and contraception, nutrition, puberty, how to talk to parents/friends/teachers, depression and anxiety and drug use/drinking.
I think teens need sensitive, practical, fact-based information that's relevant to real life and is drawn from experience - I'm here to provide just that.
Note: I am not a medical doctor, I cannot diagnose illnesses and my advice is not meant to replace the care of a qualified physician.


I have a degree in Psychology and am working towards my Masters of Public Health with the goal of being a Health Educator. In both of these fields I've spent a lot of time focusing on the needs (mental, emotional, and physical) of teens. My undergraduate courses were heavily focused on the development of the adolescent and all accompanying issues. In my graduate program, I've been enjoying learning about disease prevention/control and behavioral health science, especially as it pertains to sex education. Both in school and out,I've logged many hours mentoring and tutoring kids of all ages; competently responding and reacting to their needs and providing thoughtful direction.

East Carolina University
The Brody School of Medicine
Masters of Public Health Program

B.A. Psychology with a minor in Education
MPH Candidate

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