Mindfulness-Acceptance-Commitment Therapy for Anxiety Management in Athletes: A Systematic Review of Current Research Evidence

Abstract

Athletes engaged in high-level competition routinely face considerable psychological challenges. Among these, anxiety stands out as a widespread concern that not only undermines athletic output but also compromises both mental and somatic health. Over the past ten years, Mindfulness-Acceptance-Commitment Therapy (MAC), a leading example of third-wave cognitive-behavioral approaches, has drawn growing scholarly interest within sport psychology. The present systematic review consolidates the existing literature on MAC-based interventions targeting anxiety in athlete populations, offering a detailed examination of its conceptual underpinnings, treatment protocols, empirical effectiveness, and persistent shortcomings. Drawing on the most recent peer-reviewed studies, we seek to furnish evidence-informed recommendations for applied sport psychology. Rooted in Acceptance and Commitment Therapy (ACT) and Relational Frame Theory (RFT), MAC fosters psychological flexibility through a structured yet adaptable seven-component intervention model. The weight of current evidence indicates that MAC reliably reduces both competitive anxiety and associated somatic complaints. By comparison, investigations addressing trait anxiety and diagnosable anxiety disorders remain comparatively sparse. Moreover, treatment outcomes differ markedly across athlete subgroups, with competitive level, sport discipline, and sex acting as notable moderators. While MAC signals an encouraging conceptual reorientation in the treatment of athlete anxiety, the methodological rigor of the extant literature is uneven. Pressing gaps persist in studies concerning clinical anxiety conditions, extended post-intervention monitoring, and culturally tailored protocols for non-Western athlete cohorts.