What it is
Athletes face a unique mix of mental demands: high expectations, intense competition, public scrutiny and the constant push to perform. Performance anxiety can show up as racing thoughts before a game, overthinking a routine skill, or feeling 'frozen' at a key moment.
Focus challenges are also common. Distraction, pressure and fatigue can make it hard to stay present, follow a game plan, or recover concentration after a mistake. Many athletes notice their minds drifting to past errors or future outcomes instead of the moment in front of them.
Setbacks are part of every athletic journey. Injuries, slumps, lost competitions and transitions out of a sport can shake confidence and identity. Learning to process these experiences is something many athletes find valuable both during and after their careers.
How it’s traditionally been approached
For a long time, mental struggles in sport were often treated as something to simply 'push through.' Athletes were encouraged to tough it out, and talking about anxiety or self-doubt could feel stigmatized within competitive cultures.
Over time, coaches and trainers began paying more attention to the mental side of performance. Concepts like visualization, routines, goal setting and self-talk became common parts of how athletes prepare, alongside physical conditioning.
Today, many athletes work with performance coaches and licensed therapists who understand both the pressures of sport and the way thoughts and emotions shape performance. Mental skills are increasingly seen as trainable, much like physical ones, rather than a sign of weakness.
How a therapist may help
A therapist using cognitive and behavioral approaches may help an athlete notice the thoughts and beliefs that fuel performance anxiety or distraction. Sessions often involve exploring unhelpful thinking patterns and considering more balanced, workable ways to view pressure and mistakes.
Behavioral approaches may also focus on practical skills like managing pre-competition nerves, building consistent routines, and regaining focus after a setback. A session is usually a collaborative conversation, not a fixed protocol, tailored to what matters most to that athlete.
Performance and executive coaches often work alongside this, helping with goal setting, mindset and the practical demands of training and competition. Coaching and therapy serve different roles, and some people find value in one, the other, or both at different points.
Where mind meets body
Performance pressure is not only mental. Thoughts about an upcoming competition can trigger the body's stress response, raising heart rate and muscle tension, which in turn can feed more anxious thinking. For athletes, this mind-body loop is especially visible, since the body is the instrument of performance.
Because of this connection, some athletes pair thinking-based therapy with body-based (somatic) practices that focus on the nervous system, breath and physical tension. You can learn more about body-based options at our sister site, Somatic Experiences. Neither approach is better than the other, and many people find a whole-person combination helpful.
Explore on Somatic Experiences: athletes →Explore on Somatic Experiences: biofeedback →
Keep in mind
- Coaching, groups and self-help can support performance and well-being, but they do not treat any medical or mental health condition.
- If setbacks involve trauma, disordered eating, substance use, or thoughts of self-harm, a licensed professional should guide care.
- In a crisis, people in the US can call or text 988 or call 911.
- Any decisions about medication are made with a licensed prescriber.
Therapists who often help
Get matched privatelyFrequently asked questions
What kind of therapist helps athletes with performance anxiety?
Performance coaches and CBT therapists often help athletes with performance anxiety. Coaches may focus on mindset, routines and goals, while CBT therapists may help with the thoughts and emotions behind pressure and nerves. Some athletes work with both, depending on their needs.
Can therapy help me stay focused during competition?
Therapy and coaching may help athletes build focus by addressing distracting thoughts and the pressure that pulls attention away from the moment. Sessions are usually collaborative and tailored, not a one-size-fits-all program. The goal is to explore skills that fit how you train and compete.
How is a performance coach different from a therapist?
A performance or executive coach generally focuses on goals, mindset and the practical demands of sport. A licensed therapist is trained to work with emotional and mental health concerns using approaches like CBT. The two roles can complement each other, and some athletes find value in both.
Is performance anxiety in sports common?
Yes, many athletes experience performance anxiety at some point, from beginners to elite competitors. It can show up as pre-game nerves, overthinking skills, or freezing under pressure. Because it is so common, there are many professionals who understand it and offer support.
How can I cope after a sports injury or major setback?
Setbacks like injuries or losses can affect confidence and identity, and processing them with a professional can be helpful. A therapist may support you in working through the emotions involved, while a coach may help with practical goals for returning or moving forward. If a setback feels overwhelming, a licensed professional should guide care.
Should athletes combine mental and body-based approaches?
Some athletes find value in pairing thinking-based therapy with body-based (somatic) practices, since thoughts and the body's stress response influence each other. This whole-person approach is a personal choice, not a requirement. You can explore body-based options through our sister site, Somatic Experiences.
Educational resource. Therapists.plus shares general information and connects people with independent therapists, coaches and groups. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health. In a crisis in the US, call or text 988 or call 911.
