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Finding Your Rhythm: Conquering Musical Performance Anxiety with CBT and ACT


For many musicians, the thrill of performing in front of an audience is accompanied by the daunting challenge of musical performance anxiety. This stressor, often experienced as a blend of nervousness, fear, and self-doubt, can hinder artists from reaching their full potential on stage. In this blog post, we'll discuss how cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) can help musicians tackle musical performance anxiety and confidently embrace the spotlight.

The Crescendo of Anxiety: Musicians and Performance Stress

Musical performance anxiety, a specific type of performance anxiety, affects musicians of all skill levels and backgrounds (Kenny, 2011). It can manifest as physical symptoms such as trembling, sweating, and a racing heart, as well as psychological symptoms like negative self-talk, concentration difficulties, and fear of failure.

While some level of anxiety can be beneficial in driving motivation and focus, excessive anxiety can impair a musician's ability to perform and enjoy their craft (Yoshie et al., 2009).

CBT and ACT: Striking the Right Chord for Anxiety Relief

Cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) are evidence-based approaches proven to be effective in treating anxiety and stress-related disorders, including musical performance anxiety (Hofmann et al., 2012; A-Tjak et al., 2015).

CBT helps musicians recognize and challenge unhelpful thoughts and behaviors that contribute to their anxiety, while ACT encourages psychological flexibility, mindfulness, and commitment to values-based actions. By integrating these therapeutic techniques, musicians can develop coping strategies to better manage anxiety and enhance their on-stage performance (Juncos et al., 2017).

Online Therapy: A Convenient Option for Busy Musicians

With the increasing popularity of online therapy, musicians now have the opportunity to access CBT and ACT remotely, making it a convenient option for those with demanding schedules and frequent travel commitments (Andersson et al., 2014). Online therapy has been shown to be as effective as in-person therapy for various mental health conditions, including anxiety and stress-related disorders (Carlbring et al., 2018).


Musical performance anxiety can be a significant hurdle for musicians, but with the right support and evidence-based approaches such as CBT and ACT, it is possible to overcome these challenges. By embracing online therapy and learning effective coping strategies, musicians can confidently take the stage and let their talents shine.


A-Tjak, J. G., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A., & Emmelkamp, P. M. (2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics, 84(1), 30-36.

Andersson, G., Cuijpers, P., Carlbring, P., Riper, H., & Hedman, E. (2014). Guided Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: A systematic review and meta-analysis. World Psychiatry, 13(3), 288-295.

Carlbring, P., Andersson, G., Cuijpers, P., Riper, H., & Hedman-Lagerlöf, E. (2018). Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: An updated systematic review and meta-analysis. Cognitive Behaviour Therapy, 47(1), 1-18.

Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427-440.

Juncos, D. G., Heinrichs, G. A., Towle, P., Duffy, K., Grand, S. M., & Morgan, M. C. (2017). Acceptance and commitment therapy for the treatment of music performance anxiety: A single subject design with a university student. Psychology of Music, 45(4), 489-504.

Kenny, D. T. (2011). The psychology of music performance anxiety. Oxford University Press.

Yoshie, M., Kudo, K., Murakoshi, T., & Ohtsuki, T. (2009). Music performance anxiety in skilled pianists: Effects of social-evaluative performance situation on subjective, autonomic, and electromyographic reactions. Experimental Brain Research, 199(2), 117-126.



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