Mind-Body Integration versus Cognitive Restructuring: A Randomized Comparison of Physical-Mindfulness Therapy and Cognitive Behavioral Therapy for Stress, Anxiety, and Performance Optimization in Emerging Adult Athletes

Abstract

Competitive sport places extraordinary psychological demands on young athletes, often resulting in heightened stress, sports-specific anxiety, and compromised performance. This randomized controlled trial investigated the comparative efficacy of two promising interventions—Mind-Body Physical Therapy (MBPT) and Cognitive Behavioral Therapy (CBT)—in addressing these challenges among 100 competitive athletes aged 20–25 years recruited from sports centers in India (mean age = 22.4 years, SD = 1.6).
Participants screening positive for elevated stress and anxiety were randomly allocated to 12 sessions (3 per week, 60 minutes each) of either MBPT (integrating yoga-based movement, diaphragmatic breathing, progressive muscle relaxation, mindfulness meditation, guided imagery, and psychoeducation) or CBT (emphasizing cognitive restructuring, behavioral activation, anxiety coping strategies, performance visualization, and stress management training). Outcomes were assessed pre- and post-intervention using validated instruments: Perceived Stress Scale (PSS), Sport Anxiety Scale-2 (SAS-2), Warwick-Edinburgh Mental Well-Being Scale (WEMWBS), and a custom Sports Performance Rating Scale (SPRS).
Both interventions produced robust, statistically significant improvements across all domains (p < 0.001), with large effect sizes (Cohen’s d > 1.2). While overall efficacy was comparable, nuanced modality-specific advantages emerged: MBPT yielded greater reductions in perceived stress and somatic anxiety symptoms, likely through enhanced physiological regulation and interoceptive awareness; CBT demonstrated marginally superior gains in psychological well-being and self-reported performance, particularly in cognitive domains such as focus and self-efficacy. These findings highlight the complementary strengths of somatic-mindfulness and cognitive restructuring approaches, supporting tailored or hybrid mental training models in sports psychology. Future research should explore long-term sustainability, integrated protocols, and cultural adaptations for diverse athletic populations.