Mental skills training may ease athletes' competition nerves — but no method is a clear winner

Training mental skills — mindfulness-and-acceptance approaches, self-talk, relaxation, imagery and others — was linked to lower pre-competition anxiety in athletes across 46 randomised trials. But the trials were small, the uncertainty was wide, and the authors themselves rate confidence in the estimates as low to very low. The honest summary: practising some skill seems to help; the "best" one is not known.

What they found

The authors pooled 46 randomised trials (2,049 athletes) in a network meta-analysis, which lets different approaches be compared even when they were never tested head-to-head. The approach with the largest average effect was MAC (Mindfulness-Acceptance-Commitment: noticing nerves and thoughts without fighting them, and acting on what matters in the moment). Its standardised effect was −1.33, but with a 95 % credible range from −0.43 to −2.31. Self-talk (−0.95) and mindfulness (−0.67) also pointed towards less anxiety, with ranges running close to zero.

Patterns differed by type of anxiety and level: relaxation had the largest estimate for worried thoughts, imagery for elite athletes — but both of those ranges crossed zero, meaning "no effect" could not be ruled out. In the rankings, MAC came on average third, but it could plausibly have been anywhere from first to eighth. An exploratory analysis suggested that trials where anxiety fell more also showed better performance.

How much to trust this

Evidence: Early evidence. Many trials, but each was small: between 16 and 160 participants, about 46 on average. Of the 46 trials, 15 were judged at low risk of bias, 26 raised some concerns and 5 were at high risk. The authors' own certainty rating (GRADE) was low to very low, because of bias, very different studies and imprecise results. Participants were mostly young (average age about 20) and mostly men (two thirds). Anxiety was self-reported on questionnaires. The link with performance compares studies, not people, so it does not show that lowering anxiety caused better results.

The review was funded by Chinese academic training programmes; the authors declare no competing interests.

What this means for you

If competitions make you tense, practising one or two skills in training — not only on the day — is a reasonable, low-risk bet. Which one matters less than practising it regularly enough that it is available under pressure.

• Make room for the nerves rather than fighting them (the idea behind MAC): Three ways to unhook and Riding the wave.
• Turn the body's volume down a notch a few minutes before warming up: Paced breathing, 4 in, 6 out.
• Put your two or three skills on one card with a time to practise them each week: Build your Pressure Kit.

If anxiety around sport stops you training or competing, or spills into sleep, eating or mood for weeks, a sport psychologist or a licensed mental health professional is the right next step.

What this does NOT mean

• It does not mean mindfulness-and-acceptance is proven best: the rankings overlap heavily.
• It does not mean these skills will improve your results; the performance link is exploratory.
• It does not automatically apply to musicians, students or speakers — the trials were in athletes.
• It does not mean nerves are the enemy. Some arousal before competing is normal; the goal is a level you can work with.

Source

Li L, Wang J, Li Q, Fu Q. The Effect of Different Psychological Interventions on Athletes' Competitive Anxiety: A Systematic Review and Bayesian Network Meta-Analysis. Sports Medicine – Open, 2026 (online 22 March 2026). DOI: 10.1186/s40798-026-01007-y · PMID 41866642 · Open access: PMC13006484.