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com
ScienceDirect
Mindfulness-based and acceptance-based interventions in sport
and performance contexts
Frank L Gardner1 and Zella E Moore2
Since mindfulness-based and acceptance-based practice
models were first conceptualized and applied in sport in an
attempt to enhance performance and overall well-being of
athletes and performers, these state-of-the-art theoretical and
practice models have substantially broadened our knowledge
base and have been successfully incorporated into sport and
performance practice domains worldwide. Evolving from a
sound empirical foundation, mindfulness-based and
acceptance-based models in sport psychology have
accumulated a strong basic and applied empirical foundation.
In the nearly 20 years since their incorporation in the context of
sport, empirical findings have demonstrated efficacious
outcomes associated with performance and personal well-
being, as well as supported their theorized mechanisms of
change. Particularly as sport and performance environments
increasingly call upon practitioners to provide more
comprehensive care to clientele, including a range of care from
performance enhancement and maintenance, to general
personal well-being, to subclinical and clinical issues,
mindfulness-based and acceptance-based practitioners have
the tools to offer robust, empirically informed interventions that
can enhance skills and quality of life, and/or ameliorate
personal struggles.
Addresses
1
Touro College, USA
2
Manhattan College, USA
Corresponding author: Gardner, Frank L (frank.gardner@touro.edu)
Current Opinion in Psychology 2017, 16:180–184
This review comes from a themed issue on Sport psychology
Edited by Peter J Beek, Vana Hutter and Raoul Oudejans
For a complete overview see the Issue and the Editorial
Available online 17th June 2017
http://dx.doi.org/10.1016/j.copsyc.2017.06.001
2352-250/# 2017 Elsevier Ltd. All rights reserved.
Over nearly two decades, mindfulness-based and accep-
tance-based theories and interventions, such as Accep-
tance and Commitment Therapy (ACT) [1] and the
Mindfulness–Acceptance–Commitment (MAC) protocol
for sport [2], have dramatically altered the way sport
psychologists think about the field and what services we
can provide to athletes and performers. Essentially, based
upon contemporary research, mindfulness-based and
Current Opinion in Psychology 2017, 16:180–184
acceptance-based approaches view the manner in which
one responds to internal states such as cognitions, emo-
tions, and physiological events, and not those experiences
in and of themselves, as fundamental to understanding
competitive performance and life functioning. The prime
directive of mindfulness-based and acceptance-based
intervention models is to stimulate a modified relationship
with internal states (such as cognitions, emotions, and
physiological events), rather than attempting to alter the
form or frequency of these experiences [2]. These
approaches are distinctly in contrast with the traditional
control-based psychological skills training (PST) theories
and interventions put forward by Donald Meichenbaum
40 years ago [3], which have often been indiscriminately
adopted for use within sport psychology practice. Al-
though the traditional PST interventions sought the
attainment of an optimal internal state and perpetuated
the position that specific thoughts and emotions are
necessary for optimal athletic performance, the mindful-
ness-based and acceptance-based theoretical and treat-
ment culture suggests a rather different perspective. The
foundation of mindfulness-based and acceptance-based
models suggests that optimal performance in fact does not
necessitate volitional control (such as reduction, modifi-
cation, avoidance, or other forms of control) of internal
states, and instead promotes: (a) a full awareness and non-
judging (i.e., not good or bad) in-the-moment acceptance
of one’s internal state; (b) task-focused attentional pro-
cesses (instead of scanning for/focusing on internal pro-
cesses) with the idea that they require control or
modulation; and (c) a steady and determined values-
driven personal commitment to behaviors that are in
the service of one’s athletic values and desires [4].
Importantly then, the theoretical position that there are
good or bad, optimal or suboptimal, or positive or negative
thoughts and emotions, is replaced by the acceptance that
what exists in the human experience is a wide array of
internal events shared by us all, including competitive
athletes and performers. Following from this very differ-
ent foundation, intervention approaches such as ACT and
the MAC protocol, or other interventions that are consis-
tent with mindfulness-acceptance based model, notably
suggest a vastly different approach to working with ath-
letes seeking to enhance their performance and personal
well-being. Rather than intervention strategies intended
to create an internal state ideal for optimal athletic
performance through controlling/changing one’s cogni-
tive process or modifying one’s emotional or physiological
state, interventions based on this newer model emphasize
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 Mindfulness- and acceptance-based interventions Gardner and Moore 181
the concept of mindfulness, which has been defined as an
‘open-hearted, moment-to-moment non-judgmental
awareness’ [5, p. 24], and acceptance, which can be
defined as allowing thoughts, emotions, and other internal
sensations to come and go without struggling with or
experiencing the need to change them [2].
How did we get here?
Concerned about the dearth of empirical evidence for
traditional PST theory and interventions, and fueled by
the surmounting evidence of mindfulness-based and
acceptance-based interventions in the clinical domain
and their own use of these models in clinical practice,
Gardner and Moore conceptualized and first presented on
the Mindfulness–Acceptance–Commitment (MAC)
model in 2001 as an alternative to traditional PST theory
and intervention [4]. The MAC theory conceptualizes
performance and well-being through a more contempo-
rary evidence base, and the 7-module manualized MAC
intervention protocol allows for the effective enhance-
ment of performance and overall psychological and gen-
eral well-being of performers [6]. With modules directed
toward psychoeducation, mindfulness and cognitive
defusion, values and values-driven behavior, acceptance,
commitment, skill consolidation and poise (which com-
bines mindfulness, acceptance, and commitment), the
MAC model is the first and most detailed (and empirically
researched) mindfulness-based and acceptance-based
model within sport/performance psychology [2], and
has been central to the development of similar iterations
in subsequent years [7].
Although a full and comprehensive review of the theo-
retical literature and empirical findings supporting mind-
fulness-based and acceptance-based interventions both in
sport [see 4] and across a wide range of relevant problem
areas is well beyond the scope of this article, a substantial
and ever increasing amount of empirical research has
confirmed the efficacy of mindfulness-based and accep-
tance-based interventions for a wide breath of clinical and
subclinical areas of need (all of which affect athletes and
other performing populations), such as depression [8,9],
anxiety [10], eating pathology [11], alcohol/substance use
concerns [12], AD/HD [13], trauma-related issues [14],
emotion dysregulation [15], pain, sleep, and health con-
cerns [16–18], and many other areas. Furthermore, and of
importance for those working in sport psychology, beyond
specific clinically defined difficulties, mindfulness-based
and acceptance-based protocols have demonstrated clear
benefits for those not in excessive clinical distress,
through such outcomes as improved mood and general
psychological well-being [19], enhanced immune func-
tioning [20], and enhanced sport performance and per-
sonal well-being among athletes and performers [21,22].
In addition to the ever-growing empirical support for the
efficacy of these models, of equal importance, and as has
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been described as mandatory in some sport psychology
literature, mindfulness-based and acceptance-based
researchers have engaged in the direct study of mecha-
nisms of change of these models, which refer to the
mechanisms by which interventions based upon these
models may operate [23,24]. In this regard, comprehen-
sive reviews have clearly demonstrated that meditative
techniques indeed work via their proposed mechanisms,
and importantly, with clear neurocognitive evidence of
the expected changes in executive functioning [25], and
enhanced attentional processes [26].
Although the growing body of research evidence suggest-
ing that the mechanisms by which mindfulness-based and
acceptance-based interventions work are consistent with
theoretical assumptions [4], it may also be helpful to
note that interventions based upon mindfulness and
acceptance frameworks also appear to occur via mecha-
nisms that are fundamentally different from those assumed
to be at play among the more traditional and control-
based PST intervention methodologies [3] that once
dominated sport psychology practice. Specifically, it
appears that mindfulness-based and acceptance-based
interventions result in enhanced mental efficiency
through the development of enhanced awareness and
acceptance, and not via amelioration/alteration of specific
cognitions, emotions, or physiological sensations. Fur-
ther, the attentional self-regulation that is developed
within the systematic practice of meditative exercise
appears to result in an improved capacity to direct atten-
tion to optimal stimuli (i.e., competitive demands) without
the need to control, reduce, or eliminate competing
stimuli (i.e., cognitions, emotions, physiological states).
Again, advances in cognitive neuroscience provide strong
empirical evidence of neuroanatomical/neurocognitive
alterations consistent with mechanisms proposed by ac-
ceptance-based and meditative-based interventions
[27,28]. In total, this combination of basic and applied
research is powerful and compelling, and certainly indi-
cates that mindfulness and acceptance models can (and
should) be seen as empirically informed interventions
that are appropriate for use with athletes and other
performers. This is especially true since direct sport-
specific protocols such as MAC have garnered their
own empirical support as well.
Given the strong support in both basic science and
applied research for the theorized mechanisms, as well
as clear support for the efficacy of mindfulness-based and
acceptance-based interventions for performance en-
hancement and personal well-being, it is not surprising
that the popularity, and in turn the use, of mindfulness-
based and acceptance-based interventions in the day-
to-day practice of sport psychology have increased dra-
matically worldwide. This is most evident at the inter-
national level of elite competitive sport, where multiple
national Olympic programs fully or partially incorporated
Current Opinion in Psychology 2017, 16:180–184
182 Sport psychology
mindfulness-based and acceptance-based theory and
practice into their work with athletes and performers
[7,29–32].
Mindfulness-based and acceptance-based interventions
have developed a strong foundation of support within
both basic and applied research since the MAC program
was first introduced into the sport psychology lexicon in
earnest approximately 17 years ago. Importantly, and
consistent with an ever-increasing era of professional
accountability in which practitioners are being asked to
demonstrate that the interventions they utilize are evi-
dence-based, research into these interventions have un-
derstandably emphasized performance outcomes.
Indeed, data show that interventions based upon mind-
fulness and acceptance theoretical models are viable,
efficacious, and can lead to athletic performance enhance-
ment. Yet athletes and other performers do not perform in
a bubble. . . they are people first, with the natural array of
clinical, subclinical, transitional, developmental, intraper-
sonal, interpersonal, dispositional, regulatory, cultural,
injury-related, and identity-related experiences. Thus,
this is a day and age when sport psychologists can and
need to strive beyond an impact on performance alone
[33]. Mindfulness-based and acceptance-based interven-
tion modalities have been deemed efficacious within and
outside of the sport context for a full and wide range of
issues and concerns, and so they do not only enhance and
maintain optimal performance states, but also increase
general well-being and remediate a multitude of subclin-
ical and clinical obstacles that stand in the way of perfor-
mance success and general life functioning.
Future objectives
The accumulated basic and applied research base on
mindfulness-based and acceptance-based interventions
in the context of sport and performance has taken hold.
Yet, there is always much to learn when it comes to the
fast-paced empirical evolution of subdisciplines such as
clinical psychology, kinesiology, motor development,
sport science, developmental psychology, social psychol-
ogy, cognitive and affective neuroscience, rehabilitative
medicine, physical education, and emotion sciences (just
a short list), which are all relevant to the domain of sport
[34]. Although there are many specific avenues we hope
researchers will explore in the near future, we here
suggest just a few. First, we envision that the increasing
availability of technology will allow for the detailed study
of intervention procedures, likely making additional
fMRI studies and related neurocognitive areas more
common. This will promote further investigation of the
neural mechanisms and neural structures underlying
mindfulness-based and acceptance-based interventions
[27,28]. Second, since the sport domain is short on time
for extensive assessment and intervention, a particularly
important avenue for further research is to determine how
much meditative training (regarding dosage and total
Current Opinion in Psychology 2017, 16:180–184
hours of engagement) is needed for positive (and sustain-
able) performance, general well-being, and neural out-
comes. Finally, the issue of training, by whom, how much,
at which point of one’s training, with which type of
personal experience/commitment to mindfulness and
acceptance concepts, among others, will need further
consideration. Studies addressing these issues will pro-
vide valuable information, which at present is left to
personal opinion or experience. On a very positive note,
perusal of recent published articles, chapters, and texts in
the sport psychology discipline indicates that mindful-
ness-based and acceptance-based ideologies are flourish-
ing within the field. Just a few of the very recent
mindfulness-based publications in the sport/performance
literature include mindfulness-oriented topics on issues
such as general theory [4], emotion regulation [34],
distress tolerance [35], empirical comparison of MAC
versus PST [22], flow [36], exercise [37], body/eating
[38], medical specialties to the performing arts [39],
and on sport populations such as Olympians [32], cyclists
[40], football players [41], dancers [42], musicians [43],
elite junior athletes [44], coaches [45,46], female colle-
giate soccer players [47], military populations [48,49],
rowers [50], and socially vulnerable youth [51]. From
these basic and applied science lines, to direct interven-
tion studies, the valuable information that is gleaned from
such work is advancing the day-to-day front-line practice
and utility of mindfulness-based and acceptance-based
models, and this enhanced knowledge will result in, and
allow for, even more efficient and effective intervention
decision for the attainment of optimal performance and
general well-being among athletes and performers.
Conflict of interest statement
Nothing declared.
References and recommended reading
Papers of particular interest, published within the period of review,
have been highlighted as:
 of special interest
 of outstanding interest
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This text and the many ACT texts that have come before it, are fantastic
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the library for any third wave researcher or practitioner.
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 Mindfulness- and acceptance-based interventions Gardner and Moore 183
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Current Opinion in Psychology 2017, 16:180–184
184 Sport psychology
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