Acting with Acceptance, Mindfulness and Compassion to Cope with Test and Exam Anxiety (AcAdeMiC): Preliminary Efficacy From a Pilot Randomized Trial

Abstract Objectives Research on structured, manualized psychotherapeutic interventions for high test anxiety (TA) in adolescents remains limited, particularly those integrating acceptance, mindfulness, and compassion-based strategies. These psychological processes have been identified as protective factors for test anxiety, fostering adaptive emotional regulation and resilience. The AcAdeMiC program (Acting with Acceptance, Mindfulness, and Compassion to Cope with Test/Exam Anxiety) was developed to help adolescents manage test anxiety by strengthening these competencies, and its preliminary version demonstrated good feasibility indicators (Pires et al., 2025). Method This pilot randomized trial assessed the efficacy of a restructured version of AcAdeMiC, which consists of four sequential modules focusing on developing acceptance, mindfulness, and self-compassion as key psychological skills. The study examined efficacy throughout treatment and variance in outcome measures. Thirty-five adolescents ( Mage = 15.63 years, SD = 0.88) were randomized to either an experimental group (EG, n = 17) or a waitlist control group (CG, n = 18), but due to missing data and procedural constraints, effective sample sizes for some repeated-measures analyses included only 15 participants from the experimental group. Results The retention rate was 85.71%, with no baseline differences between groups. Self-reported ( p < 0.001; η p 2 = 0.57) and clinician-rated ( p < 0.001; η p 2 = 0.66) test anxiety severity decreased over treatment, with notable improvements between modules. Significant group x time effects were observed for test anxiety and self-compassion ( d = 0.40). Conclusions These findings offer preliminary evidence supporting the efficacy of the AcAdeMiC program in reducing test anxiety and increasing self-compassion, contributing to a biopsychosocial and contextual framework for intervention. They also provide a foundation for a larger-scale randomized controlled trial to further validate the program’s efficacy. Preregistration This trial was registered at ClinicalTrials.gov (Identifier: NCT04861116).