What do you do as an NFL psychologist?
My work involves players who have been identified as being at risk of using substances when they enter the NFL or while they are working for the organization. Players are screened randomly for a variety of substances, such as alcohol, opioid-based products, marijuana and sedative hypnotic drugs. I usually work with players from the Washington, D.C., region, but players from any NFL team can be referred to me.
If they test positive, they are evaluated by a team of mental health professionals. Then they are referred to me for an in-depth interview and further evaluation. I make a recommendation about whether to simply continue drug urinalysis monitoring or initiate therapy. Before I develop a treatment plan, I try to find out what they know about the substance they are using. They may feel that a drug is helping them cope with stress or stay focused, so we talk about the fact that no drug is benign.
Substance use is usually the tip of the iceberg — there are usually other issues that loom large, and the players have not had an opportunity to talk about these challenges, such as being a single parent, getting injured or being the first in their families to make a large amount of money, which can strain relationships. One of the players I worked with was carrying four mortgages because he wanted to help everyone in his family. He had assumed they would eventually take responsibility for the payments, but that never happened, and he had to create new boundaries with them.
In their work, the players need brute strength to be able to do what they do, but they also need a place to be vulnerable about the issues that often cause them greater pain than what they experience physically on the field. My training taught me how to use evidence-based methods like motivational interviewing to create a trusting, nonjudgmental environment where players know that I have no ulterior motive and want to get to know them as people.
Where did you get the training and experience needed to get this job?
I received excellent doctoral training at the University of Oklahoma in clinical psychology, and my supervisors put us in a variety of settings. I had exposure to many populations, including people dealing with substance abuse and addiction. That experience led to an internship at the Federal Bureau of Prisons in Oklahoma, where I worked with inmates who had entered the system on drug charges. It was a tremendous learning opportunity, which led to my next role at Aberdeen Proving Ground in Maryland. At the time, the military didn't have programs to help people using substances other than alcohol. If active-duty members were using marijuana, opioids or other drugs, they were discharged. I launched a program at Aberdeen to help treat these people. Later, I worked for the Substance Abuse and Mental Health Services Administration and then the Office of National Drug Control Policy. Those roles gave me the opportunity to examine treatment programs throughout the country and evaluate what was working and not working in different populations.
How did you find out about your current job?
In 1997, I was reading the newspaper about a high-profile football player who had been in a car accident and had been drinking. I thought, "Who treats these people?" Out of curiosity, I started calling around to find out, and one conversation led to another. One person I talked to acknowledged that there was a need for experienced psychologists who could help players struggling with substance abuse, and asked if I would be interested in working for the NFL. I had always maintained a private clinical practice even while doing policy jobs because I think it is important to continue honing your clinical skills. The next thing I knew, I had a job with the NFL Policy and Programs on Substances of Abuse. There are about 45 psychologists who work for the NFL.
What is challenging or difficult about your job?
The most difficult part is when despite every effort, change is not coming for a player soon enough to prevent the disruption of his career. That doesn't mean change won't come at some point, but he may have to go through a long, dark hallway to get there. I've worked with players who will never return to the field again, and this loss is devastating because they have devoted so many years to football at the expense of other areas of life. A little over a year ago, I was talking to a player who had been abruptly cut from the team and couldn't even talk about it. I asked what he saw after football, and he said, ‘Nothing.' He severed all contact with the team and stopped coming to therapy. Then I got a call from him a few weeks ago, and he had found a job. He told me they really liked him at his job, and he was doing all right. It doesn't get better for me than that.
What do you enjoy most?
I have learned more about football than I ever thought I would. When I see the players on the field, I don't respond to them as a fan because I see all the other issues they are facing off the field. Sometimes, it saddens me that the people do not see the entire player, and I am humbled by their ability to carry on in spite of adverse personal circumstances and criticism from fans. I typically work with players for about two years, and I enjoy watching them take some of the techniques from therapy and apply them to their lives. They start having healthier relationships with their significant others and families, and create space to just enjoy their football careers.
Is there anything else readers should know?
I think it's important to think about how you can advance your career as a psychologist. Today, particularly with reimbursement issues, clinical psychologists have to assess how they can stay economically viable. We have to get out and look around and see what's out there. It's easy to assume that a particular door is closed, but I encourage people to knock on doors and think outside the box about ways to apply their skills.
— Heather Stringer
