‘Mindfulness Acceptance Commitment (MAC) for Performance Enhancement’ with a Motivational Interviewing Framework: A RCT for Para Athletes, their Well-being and Performance

This randomised controlled trial will compare the effect of an 8-week well-being and performance enhancement program with a wait-list control group for Australian Para athletes with a physical impairments who are competing at a national level or above and aged 18 years and over. Athletes will be asked to complete pre and post intervention electronic questionnaires and semi-structured interviews in addition to completing the well-being program. The program will incorporate 8 x 1hr weekly face-to-face sessions with an investigator who holds a teacher-training certificate in Mindfulness, has been trained in Acceptance and Commitment Therapy and Motivational Interviewing, and has delivered Personal Excellence services to national and international athletes for over four years within a state institute of sport. The intervention will apply a Motivational Interviewing framework, a client-centred approach where the student investigator can use a number of strategies depending on the progress of the conversation with the athlete. Although the conversations with each athlete may be different, the underlying consistency with motivational interviewing will be maintained. Motivational interviewing is a collaborative conversation style for strengthening a person’s own motivation and commitment to change. There are four key aspects underlying spirit of motivational interviewing, these are partnership, acceptance, compassion, and evocation. The key motivational interviewing strategies when addressing ambivalence about change are engaging, focusing, evoking, and planning. Motivational interviewing strategies will be incorporated during the assessment interview, and throughout the MAC program, to encourage change behaviour, and explore and resolve ambivalence about behaviour change, and discrepancies between belief and behaviour. Motivational interviewing employs the use of open questions, affirmations, reflections and summaries during the four key processes mentioned above. As such, motivational interviewing will be used to provide participants with the choice to change, and the choice of what psycho-education tools provided within the MAC program to implement within their athletic careers. The MAC program is an integration and adaptation of Acceptance and Commitment therapy and Mindfulness Based Stress Reduction for use with an athletic population. It promotes competitive (in the moment) self-regulation necessary for optimal competitive performance as well as the valued goal commitment necessary for quality practice, intense training, and long-term development of athletic skill. The MAC program also targets decision-making, problem-solving, and behavioural processes and flexibility. The MAC program incorporates an assessment interview and seven modules - 1. Assessment interview 2. Preparing the Client with Psychoeducation 3. Introducing Mindfulness and Cognitive Defusion 4. Introducing Values and Values-Driven Behaviour 5. Introducing Acceptance 6. Enhancing Commitment 7. Skill Consolidation and Poise—Combining Mindfulness, Acceptance, and Commitment 8. Maintaining and Enhancing Mindfulness, Acceptance, and Commitment. Adherence to each of the 8 sessions will be monitored by the investigator, who will be meeting the participants face-to-face each week. If a participant cannot attend a session, the session will be rescheduled.