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Lured by increasingly big payoffs in the form of fame and fortune, elite athletes are perhaps more tempted than ever to consider using performance-enhancing drugs, say sport psychologists.

"Who's going to give the clean but losing athlete an endorsement deal?" asks Kirsten Peterson, PhD, a sport psychologist with the U.S. Olympic Committee in Colorado Springs, Colo.

Some athletes believe that because other competitors may be doping to boost endurance, speed, power and recovery, their use of prohibited substances is one way to level the playing field, says James Bauman, PhD, senior sport psychologist at the Olympic Training Center in Chula Vista, Calif.

To deter athletes from doping, the U.S. Anti-Doping Agency (USADA) subjects athletes to random urine tests immediately after competitions, during training and even while vacationing.

"That, to me, is the most deterrent aspect of the program because they never know when they'll be tested," says Richard Hilderbrand, PhD, the USADA's director of science programs.

In 2006, 7,856 urinalyses were ordered for U.S. athletes and 48 potential doping violations were recorded. The first positive test for a banned substance can result in a two-year suspension from a sport; a second can result in a lifetime ban.

But education, rather than the threat of such tests, may be even more important in deterring doping. As part of a "clean sport initiative" launched earlier this year, athletes covered by USADA's testing requirement can sign a pledge to compete clean.

"We put a great deal of effort and a lot of our budget into trying to reach the athlete and educate them," Hilderbrand says.

USADA's program offers a Web site, a hot line, a series of newsletters and a guidebook that lists the prohibited substances and techniques that is sent to athletes annually, he says.

The education efforts offer up-to-date lists of prohibited substances and methods, definitions of what constitutes doping and explanations of why clean sport is important to the well-being of athletes and the integrity of competition.

The procedures and policies for how tests are carried out, the notification process for test results and the sanction process for a positive test are also explained.

Sport psychologists also work one-on-one to deter doping when it's suspected. Indianapolis sport psychologist Christopher Carr, PhD, who works with the U.S. Diving Team and is the consulting clinical sport psychologist for the Purdue University and Indiana University athletic departments, says that he counsels athletes to consider not only the emotional and physical consequences of doping, but other negatives, including losing the ability to compete and the potential economic loss.

"My role is not to judge them," says Carr. "You're counseling them to make the most optimal decision."

At the Olympic Training Center, Bauman encourages athletes to think about their responsibility to be good role models, given what he described as the enormous influence given to them by society.

Overall, Bauman is convinced that the use of performance-enhancing drugs by athletes worldwide is not declining, and that as testing efforts increase, so do countermeasures by dopers to beat the testing process.

"The problem is much bigger than we either know or are willing to admit," he says.

Peterson tries to encourage the athletes she works with to think about their personal values and what doping means to the ideal of fair competition.

"If the rules are important, then you'd be breaking one of your core values," Peterson says.

And, of course, sport psychologists work to give their athletes a competitive edge by addressing the athletes' mental skills, Bauman says.

"We're saying there's another way to enhance your performance that's very legal, and we can't think of any bad side effects," he says.