journal article·2026-01-13Open access

The Impact of an Integrated ACT-Based Psychological Intervention (SmartACT) on Attention and Psychological Flexibility in Adolescent Student-Athletes

Timea Madár Barabási, Carmen Costea-Bărlutiu, Mircea-Nicolae Ordean, Nicola Mancini, Cornelia Popovici, Vlad Teodor Grosu, Alexandru Zadic, Rares-Mihai Pop, Dana Ioana Cristea, Emilia Florina Grosu, Emanuela Lucreția Barboni, Dan Monea

Applied Sciences· Volume 16· Issue 2

Abstract

Background: Executive functions, notably attention and processing speed, are essential for athletic performance, especially in sports that require quick reactions and decision-making under pressure. The current study aims to assess the impact of the SmartACT program—a psychological intervention that includes acceptance and commitment therapy, hypnosis, and guided imagery—on attentional processes and psychological flexibility in adolescent student-athletes. Methods: This 7-week quasi-experimental controlled study investigated the efficacy of SmartACT in adolescent student-athletes aged 15 to 18. A total of 309 individuals were divided into three groups using convenience sampling: SmartACT (n = 93), MAC (Mindfulness–Acceptance–Commitment, the standardized Gardner & Moore technique; n = 109), and control (n = 107). The d2 test was used to examine attention and visual processing, while the Acceptance and Action Questionnaire—II (AAQ-II) was used to assess psychological flexibility, both before and after the intervention. The data were analyzed using mixed-design repeated-measures ANOVA and paired-samples t-tests. Results: The SmartACT group showed significant improvement on both tests, specifically in the total number of items processed in the d2 test (457.83 to 600.24; p < 0.001), and experiential avoidance, measured by AAQ-II, decreased (18.48 to 12.80; p < 0.001), indicating increased psychological flexibility. Conclusions: The main findings of our study suggest that integrating ACT with hypnosis and imagery may enhance cognitive attentional functions and psychological flexibility in adolescent student-athletes.
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Research context

OpenAlex topics: Mindfulness and Compassion Interventions · Sport Psychology and Performance · Psychological Treatments and Assessments

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Faculty of Physical Education and Sport, “Babes-Bolyai” University, 400347 Cluj-Napoca, Romania

Faculty of Psychology and Educational Sciences, “Babes-Bolyai” University, 400347 Cluj-Napoca, Romania

Department of Physical Education and Sport, University “1 Decembrie 1918”, 510009 Alba-Iulia, Romania

Department of Science of Education and Sport, Pegaso Telematic University, 80143 Naples, Italy

Medicine Faculty, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania

Faculty of Industrial Engineering, Robotics, and Production Management, Technical University of Cluj-Napoca, 400461 Cluj-Napoca, Romania

Department of Physical Education, Sport and Physiotherapy, University of Oradea, 410087 Oradea, Romania

References (72)

Show source-provided references
1. Michalos, A.C. (2014). Cognitive Function. Encyclopedia of Quality of Life and Well-Being Research, Springer.10.1007/978-94-007-0753-5 ↗
2. Effects of Physical Activity on Children’s Executive Function: Contributions of Experimental Research on Aerobic Exercise10.1016/j.dr.2010.08.001 ↗
3. Working memory, attentional control, and expertise in sports: A review of current literature and directions for future research10.1016/j.jarmac.2016.05.001 ↗
4. Vestberg, T., Reinebo, G., Maurex, L., Ingvar, M., and Petrovic, P. (2017). Core executive functions are associated with success in young elite soccer players. PLoS ONE, 12.10.1371/journal.pone.0170845 ↗
5. Attention, working-memory control, working-memory capacity, and sport performance: The moderating role of athletic expertise10.1080/17461391.2020.1739143 ↗
6. The neurodevelopment of executive function skills: Implications for academic achievement gaps10.1037/pne0000208 ↗
7. Neural substrates for dividing and focusing attention between simultaneous auditory and visual events10.1016/j.neuroimage.2006.02.026 ↗
8. Subcategories of Attention Function and Its Assessment Methods
9. An overview of attention deficits after paediatric traumatic brain injury10.3109/02699052.2010.506853 ↗
10. Moran, A. (2008). Attention in sport. Advances in Applied Sport Psychology, Routledge.
11. Huijgen, B.C., Leemhuis, S., Kok, N.M., Verburgh, L., Oosterlaan, J., Elferink-Gemser, M.T., and Visscher, C. (2015). Cognitive Functions in Elite and Sub-Elite Youth Soccer Players Aged 13 to 17 Years. PLoS ONE, 10.10.1371/journal.pone.0144580 ↗
12. Vestberg, T., Gustafson, R., Maurex, L., Ingvar, M., and Petrovic, P. (2012). Executive functions predict the success of top-soccer players. PLoS ONE, 7.10.1371/journal.pone.0034731 ↗
13. Timea, B.M., Carmen, C.-B., Nicolae, O.M., Nicola, M., Teodor, G.V., Maria, S.A., Cornelia, P., Hervás-Gómez, C., Florina, G.E., and Dan, M. (2025). Effects of the SmartACT Intervention on Motor and Psychological Variables in Adolescent Athletes: A Controlled Trial Using BlazePod and Microgate. Children, 12.10.3390/children12101338 ↗
14. Mancini, N., Di Padova, M., Polito, R., Mancini, S., Dipace, A., Basta, A., Colella, D., Limone, P., Messina, G., and Monda, M. (2024). The Impact of Perception-Action Training Devices on Quickness and Reaction Time in Female Volleyball Players. J. Funct. Morphol. Kinesiol., 9.10.3390/jfmk9030147 ↗
15. Enhancing psychomotor skills in high school students using virtual reality
17. Examining the functionality of peripheral vision: From fundamental understandings to applied sport science
18. Activity Demands During Multi-Directional Team Sports: A Systematic Review10.1007/s40279-017-0772-5 ↗
19. Millard, L., Breukelman, G.J., Mathe, N., Shaw, I., and Shaw, B.S. (2022). A review of the essential visual skills required for soccer: Beyond 20-20 optometry. Front. Sports Act. Living, 4.10.3389/fspor.2022.965195 ↗
20. Brickenkamp, R., and Zillmer, E. (1998). The d2 Test of Attention, Hogrefe and Huber Publishers.10.1037/t03299-000 ↗
21. Hayes, S.C. (2025). Get Out of Your Mind and into Your Life: The New Acceptance and Commitment Therapy, New Harbinger Publications.
22. Acceptance and commitment therapy: Towards a unified model of behavior change10.1002/wps.20626 ↗
23. Psychological flexibility skills and mental wellbeing in athletes: An exploration of associations and gender differences10.11648/j.pbs.20241302.14 ↗
24. Effects of a Mindfulness-Based Intervention on the Physical and Psychological Well-Being in Teenagers
25. A review of return to sport concerns following injury rehabilitation: Practitioner strategies for enhancing recovery outcomes10.1016/j.ptsp.2010.07.005 ↗
26. A roadmap to rumination: A review of the definition, assessment, and conceptualization of this multifaceted construct10.1016/j.cpr.2008.10.003 ↗
27. On gender and TMT-A. The REM-ACT study: Acceptance and commitment therapy versus a mindfulness-based emotional regulation intervention in anxiety disorders. A randomized controlled trial10.1192/j.eurpsy.2021.2084 ↗
28. Effectiveness of the mindfulness-acceptance-commitment-based approach on athletic performance and sports competition anxiety: A randomized clinical trial10.19082/6749 ↗
29. Top-down modulation: Bridging selective attention and working memory10.1016/j.tics.2011.11.014 ↗
30. Moran, A.P. (2004). Sport and Exercise Psychology, Routledge.10.4324/9780203380246 ↗
31. Tenenbaum, G., and Eklund, R.C. (2007). Handbook of Sport Psychology, John Wiley & Sons, Inc.10.1002/9781118270011 ↗
32. Rahimi, A., Roberts, S.D., Baker, J.R., and Wojtowicz, M. (2022). Attention and executive control in varsity athletes engaging in strategic and static sports. PLoS ONE, 17.10.1371/journal.pone.0266933 ↗
33. França, C., Gomes, B.B., Gouveia, É.R., Ihle, A., and Coelho-E.-Silva, M.J. (2021). The Jump Shot Performance in Youth Basketball: A Systematic Review. Int. J. Environ. Res. Public Health., 18.10.3390/ijerph18063283 ↗
34. Reigal, R.E., Barrero, S., Martín, I., Morales-Sánchez, V., de Mier, R.J.-R., and Hernández-Mendo, A. (2019). Relationships Between Reaction Time, Selective Attention, Physical Activity, and Physical Fitness in Children. Front. Psychol., 15.10.3389/fpsyg.2019.02278 ↗
35. Fleddermann, M.T., Heppe, H., and Zentgraf, K. (2019). Off-Court Generic Perceptual-Cognitive Training in Elite Volleyball Athletes: Task-Specific Effects and Levels of Transfer. Front. Psychol., 10.10.3389/fpsyg.2019.01599 ↗
36. Heppe, H., Kohler, A., Fleddermann, M.T., and Zentgraf, K. (2016). The Relationship between Expertise in Sports, Visuospatial, and Basic Cognitive Skills. Front. Psychol., 7.10.3389/fpsyg.2016.00904 ↗
37. Brinkbäumer, M., Kupper, C., Reichert, L., and Zentgraf, K. (2024). Dual-task costs in speed tasks: A comparison between elite ice hockey, open-skill and closed-skill sports athletes. Front. Psychol., 15.10.3389/fpsyg.2024.1357312 ↗
38. Evaluation of D2 attention levels of orienteering national team athletes who are in education age10.11114/jets.v7i6.4204 ↗
39. Walton, C.C., Keegan, R.J., Martin, M., and Hallock, H. (2018). The Potential Role for Cognitive Training in Sport: More Research Needed. Front. Psychol., 9.10.3389/fpsyg.2018.01121 ↗
40. Renshaw, I., Davids, K., Araújo, D., Lucas, A., Roberts, W.M., Newcombe, D.J., and Franks, B. (2019). Evaluating Weaknesses of “Perceptual-Cognitive Training” and “Brain Training” Methods in Sport: An Ecological Dynamics Critique. Front. Psychol., 9.10.3389/fpsyg.2018.02468 ↗
41. Mindfulness and acceptance approaches to sporting performance enhancement: A systematic review10.1080/1750984X.2017.1387803 ↗
42. Mindfulness to Enhance Athletic Performance: Theoretical Considerations and Possible Impact Mechanisms10.1007/s12671-012-0109-2 ↗
43. Pilot Study Examining Mindfulness Intervention Effects on Perceived and Objective Stress in Adolescent Basketball Players10.29081/gsjesh.2025.26.2.11 ↗
44. Enhancing sports performance with hypnosis: An ode for Tiger Woods
45. Using hypnosis, technique refinement, and self-modeling to enhance self-efficacy: A case study in cricket
46. The efficacy of hypnosis as a treatment for anxiety: A meta-analysis10.1080/00207144.2019.1613863 ↗
47. Efecto de la hipnosis y la terapia de aceptación y compromiso (ACT) en la mejora de la fuerza física en piragüistas
48. Shimi, A., Tsestou, V., Hadjiaros, M., Neokleous, K., and Avraamides, M. (2021). Attentional Skills in Soccer: Evaluating the Involvement of Attention in Executing a Goalkeeping Task in Virtual Reality. Appl. Sci., 11.10.3390/app11199341 ↗
49. Shot differences between professional (ACB) and amateur (EBA) basketball teams, multifactorial study
50. Gutiérrez-Hernández, D.A., Gómez Díaz, M.S., García-Quezada, M.I., Olivares-Vera, D.A., and Díaz-Rodríguez, M. (2021). Comparison of test d2 with electroencephalographic signals to measure attention and concentration in university students. International Conference on Advanced Research in Technologies, Information, Innovation and Sustainability, Springer International Publishing.10.1007/978-3-030-90241-4_42 ↗
51. A review of the development of sport hypnosis as a performance enhancement method for athletes
52. Gutman, T., and Gottlieb, A. (2024). Performance mindfulness: Integrating ACT matrix, imagery and mindfulness for performance enhancement. J. Sport Psychol., 1–17.10.1080/21520704.2024.2422820 ↗
53. Mindfulness-based interventions in context: Past, present, and future
54. Hayes, S.C., and és Hofmann, S.G. (2018). Mindfulness Practice. Process-Based CBT: The Science and Core Clinical Competencies of Cognitive Behavioral Therapy, New Harbinger Publications.
55. Mindfulness: A proposed operational definition10.1093/clipsy.bph077 ↗
56. Effects of a Mindfulness-Based Intervention on Sustained and Selective Attention in Young Top-Level Athletes in a School Training Setting: A Randomized Control Trial Study
57. Acceptance and Commitment Therapy for Injured Athletes: Development and Preliminary Feasibility of the Return to ACTion Protocol10.1123/jcsp.2017-0033 ↗
58. Gardner, F.L., and Moore, Z.E. (2017). The Psychology of Enhancing Human Performance: The Mindfulness-Acceptance-Commitment (MAC) Approach, Springer Publishing Company.
59. Hunter, M.E. (1994). Creative Scripts for Hypnotherapy, Routledge.
60. Barker, P. (2013). Psychotherapeutic Metaphors: A Guide to Theory and Practice, Routledge.10.4324/9780203765838 ↗
61. Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance10.1016/j.beth.2011.03.007 ↗
62. Measuring psychological flexibility: Preliminary data on the psychometric properties of the Romanian version of the Acceptance and Action Questionnaire (AAQ-II)
63. The investigation of the factor structure, construct validity and gender related differences of the Hungarian version of the Acceptance and Action Questionnaire-II: A latent mean difference approach10.24193/jebp.2019.1.5 ↗
64. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences10.3758/BF03193146 ↗
65. Dobrean, A. (2010). Test d2–Test de Atenție [d2 Test of Attention], Romanian Testing Services.
66. Coping and experiential avoidance: Unique or overlapping constructs?10.1016/j.jbtep.2010.10.002 ↗
67. Johles, L., Gustafsson, H., Jansson-Fröjmark, M., Classon, C., Hasselqvist, J., and Lundgren, T. (2020). Psychological Flexibility Among Competitive Athletes: A Psychometric Investigation of a New Scale. Front. Sports Act. Living, 2.10.3389/fspor.2020.00110 ↗
68. The Effectiveness of Mindful Hypnotherapy on Depression, Self-Compassion, and Psychological Inflexibility in Females with Major Depressive Disorder: A Single-Blind, Randomized Clinical Trial10.1080/00207144.2022.2160257 ↗
69. Khazraee, H., Bakhtiari, M., Kianimoghadam, A.S., and Hajmanouchehri, R. (2023). The Effectiveness of Mindful Hypnotherapy on Psychological Inflexibility, Pain Acceptance, Headache Disability and Intensity in Females with Chronic Migraine Headache: A Randomized Clinical Trial. Life, 13.10.3390/life13010131 ↗
70. Increasing cognitive-emotional flexibility with meditation and hypnosis
71. Neuroplasticity and Clinical Hypnosis: Advancing Therapeutic Prospects in Neuropsychological Health and Well-being10.52711/0974-360X.2025.00339 ↗
72. Cognitive enhancement: A comparative review of computerized and athletic training programs10.1080/1750984X.2012.758763 ↗