Mindfulness-Acceptance-Commitment Therapy for Anxiety Management in Athletes: A Systematic Review of Current Research Evidence
Xu Chu, Guangda Hou, Yue Gu, Yiying Chen, Binghe Liu
Journal of Medicine and Health Science June 1, 2026 DOI: 10.62517/jmhs.202605224 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Population | Athletes |
| Intervention | Mindfulness-Acceptance-Commitment Therapy (MAC) |
| Topics | Anxiety Meditation |
| Key findings | MAC-based interventions reliably reduce competitive anxiety and somatic complaints in athletes, with effects moderated by competitive level, sport discipline, and sex. Evidence for trait anxiety and clinical anxiety disorders is limited, and methodological quality varies across studies. |
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.
Comparable studies
Other systematic reviews and meta-analyses on anxiety, most cited first.
Citations in the library
Cites 7
- Examining the Effects of Mindfulness–Acceptance–Commitment Training on Self-Compassion and Grit among Elite Female Athletes International Journal of Environmental Research and Public Health December 23, 2021
- Mobile-Delivered Mindfulness Intervention on Anxiety Level Among College Athletes: Randomized Controlled Trial. Journal of Medical Internet Research March 8, 2024
- Effectiveness of Mindfulness-acceptance-commitment based approach for Rumination, Cognitive Flexibility and Sports Performance of Elite Players of Beach Soccer: A Randomized Controlled Trial with 2-months Follow-up. Clinical practice and epidemiology in mental health : CP & EMH 2023
- Mindfulness-Based Stress Reduction Benefits Psychological Well-Being, Sleep Quality, and Athletic Performance in Female Collegiate Rowers Frontiers in Psychology September 1, 2020
- Effects of Mindfulness-Acceptance-Commitment (MAC) on Sport-Specific Dispositional Mindfulness, Emotion Regulation, and Self-Rated Athletic Performance in a Multiple-Sport Population: an RCT Study Mindfulness February 13, 2019
and 2 more in the library