Therapeutic use of silence

Therapist use of silence in therapy: a survey

Comparative Study

. 2003 Apr;59(4):513-24.

doi: 10.1002/jclp.10155.

Clara E Hill¹, Barbara J Thompson, Nicholas Ladany

Affiliations

Affiliation

¹ Department of Psychology, University of Maryland, College Park, 20742, USA. [email protected]

PMID: 12652641
DOI: 10.1002/jclp.10155

Comparative Study

Clara E Hill et al. J Clin Psychol. 2003 Apr.

. 2003 Apr;59(4):513-24.

doi: 10.1002/jclp.10155.

Authors

Clara E Hill¹, Barbara J Thompson, Nicholas Ladany

Affiliation

¹ Department of Psychology, University of Maryland, College Park, 20742, USA. [email protected]

PMID: 12652641
DOI: 10.1002/jclp.10155

Abstract

Eighty-one therapists responded to a mailed survey about their use of silence during a specific event in therapy and about their general attitudes about using silence in therapy. For the specific event, therapists used silence primarily to facilitate reflection, encourage responsibility, facilitate expression of feelings, not interrupt session flow, and convey empathy. During silence, therapists observed the client, thought about the therapy, and conveyed interest. In general, therapists indicated that they would use silence with clients who were actively problem solving, but they would not use silence with very disturbed clients. Therapists learned about using silence mostly through clinical experience.

Publication types

MeSH terms

How to Use Silence in Therapy & Counseling

Silence in talk therapy?

Silence may seem like a strange concept to highlight in a treatment based around conversation.

Still, for anyone who’s taken part in a therapy session, you know that silence is a big part of conducting or attending a therapy session.

“Silence is golden” may be an obvious cliché with which to start this article, but it holds true.

Even though silence may be uncomfortable, it can be a valuable tool for facilitating growth in treatment.

In this post, we discuss the use of silence in therapy. Readers on either side of treatment will learn about the clinical utility of silence, what silence communicates, and why therapists are sometimes so darn quiet.

Before you continue, we thought you might like to download our three Positive Psychology Exercises for free. These science-based exercises explore fundamental aspects of positive psychology, including strengths, values, and self-compassion, and will give you the tools to enhance the wellbeing of your clients, students, or employees.

This Article Contains:

The Importance of Silence in Therapy
How to Use Silence in Therapy Sessions
When to Use Silence as a Counseling Technique
Handling Silences That Feel Awkward
Practicing Silence in Group Therapy
PositivePsychology. com’s Helpful Resources
A Take-Home Message
References

The Importance of Silence in Therapy

All of my therapists have been incredibly quiet clinicians. At times, this has felt maddening; at other times, it’s been a great relief. As it turns out, these therapists weren’t trying to drive me crazy. They were using silence as a tool to facilitate my growth and allow me to work things out for myself.

We usually think of silence as the absence of talking, but silence is a positive event. It is an activity in itself that is relevant to the therapy process (Knol, Koole, Desmet, Vanheule, & Huiskes, 2020).

Psychotherapy is a unique form of conversation, one that allows for extended periods of silence. If the clinician implements silence skillfully, it can encourage clients to reflect, connect with their feelings, and continue their train of thought (Knol et al., 2020).

Silence plays a structural role in therapy, just as it does in every conversation. This role is usually to separate different topics within the discourse between speakers.

In many forms of treatment, the client usually starts the session by bringing an issue to the therapist’s attention. They discuss this initial topic for a while, often branching off into other subtopics. When silence falls, this usually signifies a change from one issue to the next (Knol et al., 2020).

Silence occurs not only between topics, but also within them. This “intra-topic” silence is a therapeutic tool that therapists can use to help their clients go deeper into the material by allowing them to think about what to say next.

This silence is a moment for reflection, where the client gets to let their psychological processes happen without the input or interference of the clinician (Knol et al., 2020).

Silence can also be a therapeutic event within itself, a moment in which the client can dig deeper into the emotional experience they are having in the session (Knol et al. , 2020).

Therapists can choose to turn silence into a therapeutic event by bringing it to the client’s attention in the conversation. By talking about the silence between them, the silence itself becomes material for the therapy.

As we will explore, there are many uses for silence in therapy. It is more than just the absence of talking. It is one of the most vital aspects of treatment.

How to Use Silence in Therapy Sessions

Silence is a powerful tool for a therapist to have at their disposal.

A good time to use silence is if a client brings a problem to the session, and the clinician does not know what to say.

Sometimes not saying anything can be more effective than saying something mindless, because it gives the client a safe space to reflect.

How a therapist thinks about silence depends on their theoretical orientation. Therapists’ use of silence in psychotherapy includes:

Conveying empathy
Facilitating reflection
Challenging the client to take responsibility
Collecting their thoughts before responding (Valle, 2019)

Another way to use silence is to help the client reflect on a situation in which they feel overwhelmed by input from significant others in their lives.

An example would be a much-beloved person who is thinking about taking a job in a faraway city. This person’s family and friends have many opinions about the move and have let them know it. By the time the person reaches therapy, they have so many other people’s ideas in their head that they cannot get in touch with their feelings.

Allowing this person to talk and reflect and then sit in the silence of their feelings can be enormously helpful for sorting through the noise of others’ opinions.

One more way to use silence in therapy is for meditation. Many clients want to learn how to meditate, but they cannot find a quiet space or bring themselves to seek silence in their everyday lives.

As a therapist, you can use the controlled space of your office to help the client comfortably experience the silence of meditation.

When to Use Silence as a Counseling Technique

A simple answer: probably not at the beginning.

Therapists usually make sure there is a solid therapeutic alliance before using silence in their therapy sessions (Valle, 2019).

Educating the client on how and why they use silence can help ease the client’s anxiety. It would be strange and ineffective to show up to a meeting with a new therapist, only to find that they were entirely quiet from the very beginning.

Additionally, therapists typically use silence more frequently with specific clients. Some therapists note that it is a more effective tool with higher functioning clients, finding it less helpful or even harmful with psychotic, highly anxious, or angry clients (Valle, 2019).

Highly talkative clients may benefit from using silence in a session, but clinicians need to gauge if clients are talking so much because they are highly anxious. Here, psychoeducation may be critical.

Therapists may use silence as an invitation to reflect. It is up to the clinician to sense these moments and extend the invitation for silence by either sitting quietly or explicitly encouraging reflection.

Such a pause is beneficial after a therapist has responded empathically to the client’s revelation of a challenging subject (Valle, 2019). This silence gives the client another moment to feel and react to what is happening in the session.

Timing and alliance are everything here. If the therapist uses silence without skill or sensitivity, the client may feel this as distance, disinterest, or disengagement (Valle, 2019). Every client, alliance, and session are different. Therapists shouldn’t be afraid to use silence, but they should explain their approach and work to repair rifts if the attempt does not go well.

Handling Silences That Feel Awkward

When you think about it, therapy is an awkward way to relate to someone else.

You can notice this quickly in the reactions of a new client.

When you open the floor to someone who has never been to therapy before, there are two common reactions: the person will talk and talk, filling the space with their words, or a stark opposite, when the person may have no idea what to say and sits silently, waiting for you to say something.

As much as we talk about improving our therapy skills to help clients, it is essential to remember that the client must have the skill to actively take part in their treatment. Like with any skill, the client’s ability to get the most out of therapy requires practice and time to develop.

When encountering awkward silences at the beginning of a therapy engagement, it is important to remain patient with the client, who is probably flexing these therapy muscles for the first time.

Therapy is also awkward because people are generally uncomfortable talking about themselves, especially with strangers and in the depth required for treatment. They may be afraid that their therapist sees them as self-absorbed or boastful, especially when they say something positive about themselves or how others perceive them.

If the client voices any of these concerns, it is important to normalize the reaction so the client can feel comfortable enough to keep going.

However awkward you may feel in this situation, it is important to stay composed and calm.

Avoid filling the awkward silences with your unpolished thoughts. Suppose you are anxious during silence and jump in to end it. In that case, you may signal to the client that something is wrong when it is quiet, which may make them feel more awkward during the silences than necessary. This response could encourage them to talk endlessly to keep the conversation going, which essentially eliminates the space needed for reflection.

Practicing Silence in Group Therapy

Silence in group therapy can perform many of the same functions as silence in individual therapy: providing space for reflection, allowing room for mindfulness practice, and compelling clients to speak through the sheer awkwardness of silence.

However, the context of group therapy is unique in that clients experience it in the company of their peers. Therefore, there are some opportunities for togetherness that individual therapy does not provide. Silence, which is often thought of as isolating, can be an experience that brings the group together, as each client sits and reflects on their thoughts.

In group therapy, silence can play an important role in progressing the conversation by giving each party the time to think and respond (Valle, 2019). Many people feel awkward in moments of silence around others. They may fill the space with their talk. For individuals with this issue, group therapy can help them be more comfortable and reflective during periods of silence.

Silence can also be counterproductive in group therapy.

Although members can learn and grow vicariously through other group members’ work, they are more likely to benefit from the treatment if they are verbally engaged during the session (Lieberman, Yalom, & Miles, 1972).

Silence can also be a sign of resistance or disengagement, but it’s important not to jump to this conclusion. It can take considerable time and effort for a group to be cohesive enough to keep up a proper therapeutic dialogue in which group members interact with and help each other.

When silence is the norm or the quality of the silence is impenetrable and stifling, it can signal group dysfunction (Wood, 2016).

If your group starts silent, do not despair. There are many things you can do to help improve the cohesion of your group, which we discuss in our Ultimate Group Therapy Guide.

The ultimate text on group therapy is The Theory and Practice of Group Therapy by Irvin D. Yalom and Molyn Leszcz (2020). Within its pages, you’ll find many ways to navigate group silence effectively.

PositivePsychology.com’s Helpful Resources

We have an excellent selection of resources to aid therapy sessions. Many are part of the toolkit, but we mention them here, and also provide you with links to related articles.

Toolkit tools

The Positive Psychology Toolkit is full of tools to help you cultivate your listening skills and use silence in therapy more efficiently, helping your clients make and enjoy quiet time.

Here are some relevant tools for using silence.

Creating Quiet Time

Some clients seem incredibly uncomfortable with silence during a therapy session. These may be people who do not take any time in their daily lives to experience quiet.

Creating quiet time is a tool which helps you and your client set aside time to experience silence during the day. The tool provides a framework for structuring interventions centered around silence in a session.

Mindful Speaking

The other side of silence is speaking. We have all said things we’ve later come to regret. Often this can be magnified when embodying the role of the therapist.

If you have been using silence in your work, then the words you say will be incredibly weighty since you will be speaking less. Use the Mindful Speaking tool to help yourself practice mindful speaking in your work or to help your clients cultivate this skill in their everyday lives.

Mindless Versus Mindful Listening

The Mindless Versus Mindful Listening tool is another mindfulness practice that helps develop a sense of inner calm and present moment awareness. Practicing mindful listening can allow you to be truly present with your client. It can also be a valuable practice to help your clients develop deeper connections with significant others in their lives.

Practicing Empathic Listening

There are an incalculable number of practices that can improve your listening skills. In empathic listening, the skills you will improve are pausing, paraphrasing, and reflecting.

Use the Active Listening in Session worksheet to help build your empathic skills and strong therapeutic alliances with clients.

17 Positive Communication Exercises

If you’re looking for more science-based ways to help others communicate better, this collection contains 17 validated positive communication tools for practitioners. Use them to help others improve their communication skills and form deeper and more positive relationships.

Relevant blog posts

What Is Psychodynamic Therapy? 5 Tools & Techniques

Psychodynamic therapy is a treatment that started with Sigmund Freud and is still used today in many forms. Practitioners of psychodynamic therapy are experts in using silence to help their clients. This article offers five tools to use in your practice.

Psychoanalysis: A Brief History of Freud’s Psychoanalytic Theory

If you go to a psychoanalytic therapist, you will probably be struck by how little they speak. When they do speak, the power of their words is evident. Psychoanalysis is also the first psychological treatment, and understanding its history can help put today’s therapy in context.

What Are Distress Tolerance Skills? Your Ultimate DBT Toolkit

Dialectical Behavioral Therapy (DBT) is not a treatment known for its use of silence. Still, it has something to offer in helping clients tolerate silences in therapy and their everyday life.

If you or your client has difficulty sitting in silence, you may want to consider some DBT skills of distress tolerance. They can help you ride out uncomfortable experiences and use silence to your advantage.

A Take-Home Message

In therapy, silence is much more than the absence of talking.

It is one of the foundational elements of making treatment work.

This article has broken down the different ways you can use silence in your clinical work to help connect with clients, help clients solve their problems, and help improve their mindfulness skills and comfort with ambiguity.

If you find yourself chatty in the therapy room, there is nothing wrong with that, as long as you are speaking with purpose. If not, consider practicing silence in your own life and transferring your newfound skills to the therapy room.

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free.

Knol, A., Koole, T., Desmet, M., Vanheule, S., & Huiskes, M. (2020). How speakers orient to the notable absence of talk: A conversation analytic perspective on silence in psychodynamic therapy. Frontiers in Psychology, 11.
Lieberman, M. A., Yalom, I. D., & Miles, M. B. (1972). The impact of encounter groups on participants: Some preliminary findings. The Journal of Applied Behavioral Science, 8(1), 29–50.
Valle, R. (2019). Toward a psychology of silence. The Humanistic Psychologist, 47(3), 219–261.
Wood, D. (2016). On working with opaque silence in group psychotherapy. Group Analysis, 49(3), 233–248.
Yalom, I. D., & Leszcz, M. (2020). The theory and practice of group psychotherapy (6th ed.). Basic Books.

"How did two decisions get made on one report?" – Ogonyok No. 32 (5442) dated 08/15/2016

4K 5 7 min. ...

What is behind the suspension of the Russian Paralympic team from the Games in Rio de Janeiro

Sochi-2014 (next to President Vladimir Putin, RCC Secretary General Mikhail Terentiev) was a triumph for our Paralympic athletes. Who would have thought then that in two years they would be removed from the Games altogether?

Photo: RIA Novosti. illogical. Of course, there is still time before the Paralympics - it will begin in September, so there is a chance to sue such a decision of the International Paralympic Committee (IPC). But what is behind it? Ogonyok asked about this from a member of the Council of Athletes of the International Paralympic Committee (PCR), chairman of the All-Russian Society of the Disabled, State Duma deputy and winner of six Paralympics Mikhail Terentyev.

- Mikhail Borisovich, what kind of doping can we talk about when we talk about Paralympic athletes - people who sometimes have to constantly take medication?

- Disabled people involved in elite sports are not infirm people. Disability is not a disease, but a condition of the body. So Olympic and Paralympic sports differ only in the rules for classifying athletes. For Paralympic athletes, this means that wheelchair users must compete with wheelchair users, and the blind with the blind. But the doping requirements for both Olympians and Paralipians are the same. As well as permission for the therapeutic use of drugs - this is possible only on the recommendation of a doctor in the case when it is vital for the health of the athlete. The procedure for informing WADA about the use of drugs by an athlete is the same.

— Do the banned drug lists also match?

— Yes, the list is general and approved by WADA, and controlled by the International Paralympic Committee and the International Olympic Committee. National committees, including the Russian one (PKR), are deprived of the right to interfere in the process.

— That is, the Russian Paralympic athletes were accused of using doping, not drugs?

- Nothing like that! The accusation does not concern the use of doping by Paralympic athletes, but the fact that Russia has a state program that is aimed at the use of prohibited methods and drugs. The West suspects that at the state level all these violations are hidden from other countries. If we were talking specifically about doping, athletes would be disqualified on an individual basis on the basis of doping tests. But Olympic athletes or the entire Russian Paralympic team were suspended not because of a positive result of doping tests, but because, according to WADA, under the current conditions, the RPC cannot function normally.

— Why was the entire Paralympic team suspended?

— That's why the decision of the IPC came as such a shock to us! How, according to the information from the same report, two such different decisions were made? Absurd!

— But is there any logic here?

— The IOC and the IPC are guided by the following consideration... Since sports federations structurally manage sports and apply for the Games, in the Olympic system the decision was left at the mercy of these same federations. Paralympic athletes have a different system: there are several Summer Olympic sports that are directly administered by the IPC (for example, athletics, shooting, swimming, powerlifting). Therefore, the decision to remove the Russians had to be taken by the IPC, and they could not be eliminated, as the IOC did. And the decision could be only one for the whole team. It was accepted on the basis of data from the report of Richard McLaren (independent WADA expert. - "O" ), where it was, I repeat, about the alleged creation of a state doping system.

— Were there any precedents in the history of the Olympic movement?

- Suspension of the national team due to doping - no, but there were political accusations against states, for example, in violation of human rights. As were the removal of national teams by Nazi Germany and South Africa during the apartheid regime. Therefore, the newly created anti-doping commission, headed by Vitaly Smirnov, proposed that the Russian anti-doping agency be coordinated not by the Ministry of Sports, but by the Ministry of Health. This should break the imaginary "vertical" of the supposedly existing doping corruption system in the imagination of foreigners.

— And what is the conclusion drawn from what happened?

- WADA needs serious reform. This is not my thought, but IOC President Thomas Bach. Because the Anti-Doping Rule Enforcement Authority must provide all information clearly and concisely at once. But what is it really? WADA first announces the charges, and then presents the documents in parts. It seems like a solid organization, but behaves like a card cheat. Until July 18, there were no claims from the IPC against the RCC. All this time there was an active correspondence. Just after November of last year, the RPC provided an explanation regarding track and field athletes, notifying the IPC that Paralympic athletes were training separately from Olympians. At the same time, the IPC was asked if there were any complaints, and there were none. And WADA gave the same answer to a similar question. And suddenly - a report on July 18 with 35 doping tests. We asked to provide at least the names of sports where there are violators, and better their names - silence in response. A week later, they sent a list and immediately showed up themselves: they say, we began to figure it out, out of these 35, 20 people are not your athletes. Well, we agreed and asked once again to send the data only for our athletes. Sent. We look: the list includes, for example, an athlete whose doping test, according to WADA, was changed at the Sochi Olympics. We find out: this athlete was not in Sochi. Next - "freestyle wrestling" is on the list... We turn to WADA for clarification: what kind of sport is this? Because it is not among the Paralympic. But WADA, apparently, did not even look at the IOC official website to find out... And on August 3, the IPC reported that WADA still has either 10 or 19offenders. We wanted to look at the names. We waited and looked: someone had been disqualified for a long time, someone used drugs for therapeutic purposes, which was announced in a timely manner, and some of the names of non-existent "heroes" do not exist, there are no such athletes. I am in favor of tough decisions being made only on the basis of verified data.

— Can the IPC decision be appealed?

— This work is already underway. The RPC and the IPC decided to speed up the procedure and file a claim not with a special commission, but with international sports arbitration. He will meet on August 21st.

— What role did the desire to eliminate medal competitors play in the decision to suspend Russian Paralympic athletes?

— I cannot answer this question, because the answer will be from the category of speculation. But you yourself can draw conclusions if you analyze the number of medals received by our Paralympic team in Sochi, London, and ask how the UK itself ended up in third place ... Of course, Phil Craven (President of the IPC. - "O" ) will not tell you that he was guided by such motives when making a decision. But there is a moment that can indirectly confirm your guess... A few years ago, the program of the Summer Games was analyzed, the criteria were determined on the basis of which sports were selected for the Games in Rio. Thus, football for people with cerebral palsy in Brazil will be held for the last time. It has already been excluded from the program of the Tokyo 2020 Games due to the fact that there were few teams. Probably a coincidence, but for 15 years now the medals in this sport have been alternately received by Russian and Ukrainian teams. There is a kind of competition when amputees put the shot... Our Alexei Ashapatov has been in the lead more than once, and in Rio this discipline is excluded - there are few athletes. It's hard to prove anything, because the IPC has its own arguments - they advocate for Paralympic sport to be more competitive.

We know that 50 percent of the Anti-Doping Agency is funded by the IOC, and another half comes from some independent sources. But what are these sources and how much do they influence decision-making?

— Will suspended Paralympic athletes go to court?

- First, let's wait for the verdict of sports arbitration, read its wording. If the verdict is negative, of course, they will apply. Athletes were preparing, spent energy, money, time. But first we need to deal with the facts. And then with WADA, to understand how independently they make a decision. We know that 50 percent of the Anti-Doping Agency is funded by the IOC, and another half comes from some independent sources. But what are these sources and how much do they influence decision-making? I have not personally heard of the IPC funding WADA.

Are the Paralympic Games really in their heyday?

— Yes, and, in my opinion, this is largely due to the huge social role of the Games. They are changing society. Looking at how Paralympic athletes perform, people understand that if disabled people have such potential in sports, then it can be in all spheres of life. Games are watched by 3 billion people. And this affects everyone who is at the stadiums and at the screens: first of all, other disabled people who stay at home and are afraid to leave it. Not to mention that only those states that can create an "accessible environment" in the host cities are allowed to receive an application to host the Paralympic Games. Local disabled people also benefit from this, not only athletes and participants in the Games.

— Russian Olympians booed in Rio. Should Paralympians be subjected to such stress?

- I agree that such an attitude is stressful for any athlete. Of course, this is not the case in Russia, but in Rio there is a different information space, where all events are presented differently. It's no wonder audiences react this way. But it would be right to refuse a trip to Rio, perhaps only for officials. For 268 members of our Paralympic team, who trained for 4 years, went through a tough selection (there were twice as many applicants), participated in the World and European Championships, this would be a failure. How can you deprive them of a well-deserved struggle?

Svetlana Sukhova talked to

Honitant Card 9015

Sports character

Mikhail Terentyev, a native of Krasnoyarsk (1970), since 1984 he was engaged in skiing biathlon, in 1986 at the competition in the city of Kirov, he was injured by a spinal only in a wheelchair. Graduated from the Faculty of Economics of Krasnoyarsk University, in 2009 — the Diplomatic Academy of the Russian Foreign Ministry (international relations). Since 1993, he began active training in cross-country skiing and athletics among the disabled. Paralympic participant in Lillehammer (1994), Nagano (1998), Sydney (2000), Salt Lake City (2002), Athens (2004) and Turin (2006). Paralympic champion in cross-country skiing, winner of 4 silver medals in cross-country skiing and 2 bronze medals in wheelchair biathlon (world champion in this sport). In 2006-2008 - acting President of the Federation of Physical Education and Sports of Russian Disabled People with Musculoskeletal Disabilities, 2006-2014 - Secretary General of the Paralympic Committee of Russia, since 2014 - Member of the Council of Athletes of the International Paralympic Committee, since 2014 - Chairman of the All-Russian Society of Disabled People, Deputy of the State Duma of the 5th and 6th convocations.

The period of disqualification for the first time caught doping will be increased to four years

The period of disqualification for the first time caught doping will be increased to four years - Gazeta.

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05 February 2013, 17:28 Sport

100%

WADA will increase the ineligibility for a first anti-doping violation to four years, but will retain the ability to open the B control sample. At the same time, the statute of limitations for doping offenses will be extended to 14 years.

An extraordinary meeting was held in Strasbourg as part of the Council of Europe meeting to discuss changes to the WADA World Anti-Doping Code, which will come into force on January 1, 2015. The main innovation of the World Anti-Doping Agency was the increase in the period of ineligibility for the first violation to four years, the control sample “B” was eventually decided to be left, and the statute of limitations for initiating cases was extended to 14 years.

Details of the meeting and future changes were given to the agency "All Sport" by the head of the anti-doping department of the Ministry of Sports Natalya Zhelanova, who took part in the meeting along with RUSADA specialist Anna Antselovich.

“The new version of the Code will be adopted by the WADA Board of Founders at the doping conference to be held November 12-15, 2013 in Johannesburg,” said Natalia Zhelanova.

“I will highlight a few of the highlights that were discussed at the meeting in Strasbourg. When discussing the new version of the WADA Code, there were proposals to remove the “B” control sample. But this caused a lot of discussions of all interested parties, and the control sample "B" was decided to be left. Detailed issues related to the issuance of permits for the therapeutic use of illicit drugs (therapeutic exception). If an athlete competes at the national level, a therapeutic exception is issued by the National Anti-Doping Organization (in Russia it is RUSADA). If an international-level athlete, a request for a therapeutic exception is submitted to the international federation. At the same time, WADA calls on international federations to recognize therapeutic exceptions issued by NADO,” Zhelanova said.

“The new version of the WADA Code expressly stipulates that testing can be conducted anywhere at any time by any anti-doping organization that has jurisdiction over an athlete,” continued Natalia Zhelanova.

- The standard period of ineligibility for a first offense has been increased to four years, with a few exceptions. The system of proving negligence and intent in order to reduce the sanction is complicated. All Athlete results achieved during the period of Ineligibility will be void, even in the event of a retroactive Ineligibility. The statute of limitations for filing a case has been extended from the current eight years to ten years for possession and use of prohibited substances, and for other anti-doping rule violations (such as prescription or distribution) to 14.

Finally, it is proposed to amend the article concerning the classification of a substance as prohibited. There are still three criteria left: the ability to improve sports performance, potential harm to health, and contradiction to the spirit of sport. However, whereas previously a substance had to meet any two of the three criteria in order to be included in the prohibited list, now one mandatory criterion is the ability to improve the result. ”

For more news and information see page summer sports.

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