Let’s take a time machine back to late October.

The Hawkeyes had just downed the Northwestern Wildcats 33-13. Quarterback Spencer Petras played arguably his best game of the 2022 season, completing 21 of his 30 pass attempts. But it wasn’t even a sure thing he would be starting that week.

He had been benched at halftime the week prior in Iowa’s 54-10 defeat at the hands of the Ohio State Buckeyes. No starter was named until hours before the game. After Petras’ start — and quality performance — a reporter asked him who’s been in his corner during the difficult stretch.

“I meet with our sports psychologist at least twice a week in-season,” Petras revealed. “Carmen — she does a great job after weeks like last week, I meet with her more than twice. She’s really helpful.”

Carmen Tebbe Priebe has been serving athletes as a sport psychologist for nearly two decades. She earned her master’s degree in psychology from Wake Forest and directed the University of Oklahoma athletics’ psychology department for 5 years. In 2016 she began providing counseling for the Iowa Hawkeyes.

Tebbe Priebe works directly with Iowa’s football and women’s basketball as the team’s assigned sports psychologist. She’s one of the athletic department’s two primary therapists, who supervise a few consultants and trainees.

“We’re trained in typical clinical activities in terms of treating mental health disorders such as depression, anxiety, eating disorders, etc. A sports psychologist is specifically trained to treat those within the performance realm.”

Athletes and coaches on the team can schedule 1-on-1 visits in a confidential environment. But Tebbe Priebe’s place of work spans farther and wider than her office. She works on the sidelines for practices and games to observe the team.

“I’m observing body behavior, body language after a mistake, communication, just general demeanor in terms of how they’re responding to the events of a game,” Tebbe Priebe said. “Gameday is where I’m gathering performance data.”

Athletes are subject to mental health screeners when they arrive on campus. However, the services are available to anyone — diagnosis or not.

“Our services range from what typical clinical services might be from like depression, anxiety, all the way to ‘things are going well I would just like them to be better,'” Tebbe Priebe shared. “Just having an outside objective person that they would like to get support from.”

There’s no set-in-stone limit on how often clients can meet with their assigned clinician, the approach is “be available but not obnoxious,” according to Tebbe Priebe. However, having close proximity to the team is paramount — and assigned clinicians travel with the team on the road too to accommodate athletes.

At that press conference post-Northwestern, Petras talked about the importance of seeing a psychologist earlier in the season, too. Those visitations paid dividends, especially when Petras was dealing with vocal disappointment from the Hawkeyes’ home crowd.”

“Coming to the sideline, hearing the boos. If you don’t have mental health coaching or mental skills coaching you can really get affected by that,” Petras said. “She does an outstanding job and meets with a lot of guys on the team and helps. It’s really what I need, I think. It varies week to week. The big thing for me is staying grounded. Working on techniques and physical releases to keep yourself in the moment.”

When it comes to countering criticism, Tebbe Priebe says she encourages her clients to refrain from using social media as much as possible.

“I call it Russian roulette,” Tebbe Priebe joked. “You just never know when you pick it up what you’re going to see and how it’s going to affect you.”

“We do a lot of work on determining your inner circle and the credibility of the voices that you listen to,” she said. “And I think we’re susceptible to outside opinions. These young adults — they’re impressionable.”

Tebbe Priebe is a specialist in the “performance optimization” realm, serving and observing athletes. But the title “sports psychologist” encompasses her expertise as a clinician and the ability to treat mental health disorders like anxiety and depression — and the physical symptoms they can trigger.

“Appetite and sleep disturbance, that might show up in the performance realm, or at least cause stress in the performance realm,” Tebbe Priebe said. “The pressure and the heaviness, the stress, can make it harder to work through it, as well as the “Am I going to lose my role?” or “What will people think of me?”

“There tends to be some judgment that they give themselves. It can sometimes hinder treatment but a lot of times it can help treatment. Because we have the structure, we have the social support, we have easily accessible services, so there’s a lot of ways that athletics can be a protective or a risk factor. Everything is just very individual.”

Treating an individual athlete is one thing, treating a group of people individually who are competing with and against each other is another. Players battling for prominent roles and the natural politics that come from group settings. It could be an uncomfortable situation for a client and a dangerous path for a clinician — who requires written consent to share matters discussed during meetings.

“Our goal is to treat each person as its own individual,” Tebbe Priebe said. “I am always discussing confidentiality. Even if there’s the perceived threat of the coaching staff or somebody else knowing something, they may not feel comfortable there, so we’re constantly going through that. If they want me to share anything with the coaching staff, then they have to sign a written release to give me permission to do that.”

Speaking of the coaching staff, Iowa head coach Kirk Ferentz shared some thoughts on mental health services after that Northwestern game too.

“I’m all for it,” Ferentz said. “We try to encourage guys to budget their time and be careful about whose opinions you’re really paying attention to, because it can do a lot of damage. It’s a no-ending battle, that’s for sure.”

Petras, Ferentz and countless others speaking out on the importance of mental health have helped break the stigma. Segwaying around other Hawkeye sports, basketball star Patrick McCaffery announced his leave of absence to address anxiety.

Tebbe Priebe says the dramatic shift in how athletes view mental health has altered the demands of her job.

“The need for mental health services — we’re no longer explaining the need for it, we’re just trying to fill the need,” Tebbe Priebe said. “This is across all college students. I think if you asked the psychologists on campus, they’d say the same thing. Our field has experienced tremendous growth. The past few years it’s been really exciting to see that mental health has had a little bit less stigma, I think we still have a way to go but there’s been so many more professional and elite athletes that have been more transparent about their challenges. I think that’s been helpful for this generation to see that.”

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