Juncos & de Pavia e Pona 2018

Acceptance and commitment therapy as a clinical anxiety treatment and performance enhancement program for musicians

In this article the authors discuss the various options available to musicians wanting to treat their music performance anxiety (MPA), and they recommend that musicians work with a performance psychologist over the other available options. The authors also discuss the potential for Acceptance and Commitment Therapy (ACT) to serve as both a clinical anxiety treatment and performance enhancement program for musicians, while addressing the state of the research for both applications, as well as the research for a similar, mindfulness and acceptance-based performance enhancement program for athletes, i.e., the Mindfulness–Acceptance–Commitment (MAC) approach.

In order for the field of performance psychology to develop into a more credible discipline, the authors believe practitioners working with musicians should follow an evidence-based practice model of care, in which empirically supported treatments for MPA and performance enhancement are promoted, and information about such treatments is disseminated among practitioners, musicians, and music teachers. Such a practice must become the norm in this field, because it will ultimately result in greater protections for those musicians seeking help for performance-related challenges by ensuring a higher level of professional accountability among practitioners. Lastly, the authors discuss some issues that may arise when applying ACT or the MAC approach to musicians.


Juncos et al 2017

Acceptance and Commitment Therapy for the Treatment of Music Performance Anxiety: A Pilot Study with Student Vocalists

This study investigated the use of Acceptance and Commitment Therapy (ACT) as a treatment for music performance anxiety (MPA) in an uncontrolled pilot design. ACT is a newer, “third-wave” therapy that differs from previous MPA treatments, because its goal is not to reduce symptoms of MPA. Rather, ACT aims to enhance psychological flexibility in the presence of unwanted symptoms through the promotion of six core processes collectively known as the ACT “Hexaflex.” A small group of student vocalists (N = 7) from an elite choral college were recruited using objective criteria for evaluating MPA. Participants received 12 ACT sessions, and their baseline functioning served as a pre-treatment control. Treatment consisted of an orientation to ACT, identifying experientially avoidant behaviors, facilitation of Hexaflex processes, group performances in which valued behaviors were practiced in front of one another, meditations, homework, and completion of self-report measures before, during, and after treatment (at a 1- and 3-month follow-up). Improvements were observed in participants' cognitive defusion, acceptance of MPA symptoms, and psychological flexibility at post-treatment and follow-ups. Students also appeared to improve their performance quality and reduce their shame over having MPA. These results add to existing research suggesting ACT is a promising intervention for MPA, while also highlighting how vocal students may be less impaired by physical MPA symptoms.


Juncos & Markman 2015

Acceptance and Commitment Therapy for the treatment of music performance anxiety: A single subject design with a university student

This study marks the first application of Acceptance and Commitment Therapy (ACT) to the treatment of a university student with music performance anxiety (MPA). ACT is a newer, “third-wave” therapy that differs from previous MPA treatments, because its goal is not to reduce symptoms of MPA. Rather, ACT aims to enhance psychological flexibility in the presence of unwanted symptoms through the promotion of six core processes collectively known as the ACT “hexaflex.” For this study, an undergraduate violinist with debilitating MPA received a 10-session ACT treatment using a single-subject design. Treatment consisted of an orientation to ACT, identification of experientially avoidant behaviors, facilitation of hexaflex processes, in-session performances in which valued behaviors were practiced, meditations, homework, and regular completion of ACT-based and symptom-based measures. Clinically significant improvements were observed in her ability to accept and defuse from her anxious thoughts and feelings at post-treatment and at a 1-month follow-up. Her performance quality also improved at post-treatment. Although symptom reduction was not a goal, her MPA and overall distress were significantly reduced, and her perceived control over MPA significantly improved at post-treatment and follow-up. These results suggest ACT may be an effective treatment option for MPA and should be studied further.