CBT-based interventions in athletes: a systematic review

This systematic review examined the effects of cognitive-behavioural therapy (CBT)-based interventions on athletes’ psychological and behavioural outcomes and sport performance. The review was pre-registered in PROSPERO and conducted according to PRISMA 2020. Searches identified 197 records; 34 full-text reports were assessed, and 13 studies involving 289 athletes were included. One reviewer conducted study selection, with verification by another; inter-rater reliability was not calculated. Findings were synthesised narratively, prioritising controlled designs, repeated measurement, clearer intervention descriptions, and follow-up assessment.The most consistent findings concerned reductions in maladaptive cognitions, particularly irrational beliefs, and improvements in anxiety, stress, and emotional responses to sporting demands. Several studies reported improvements in self-acceptance, resilience, motivation, self-efficacy, psychological flexibility, and wellbeing. Performance findings were less consistent: some studies reported improvements in simulated or perceived performance, performance satisfaction, or golf-related indicators, whereas others showed limited or unclear effects.CBT-based interventions may support athletes’ psychological functioning and adaptive responses to competitive stressors. However, small samples, heterogeneous designs, variable outcome assessment, and inconsistent follow-up limit conclusions. Further controlled research should compare CBT approaches and establish whether psychological improvements translate into durable, practically meaningful performance benefits.