Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2025 Apr 19;25(1):578.
doi: 10.1186/s12909-025-07130-w.

Impact of cognitive-behavioral therapy and mindfulness-based stress reduction in mitigating test anxiety and enhancing academic achievement among vocational education students at Nigerian universities

Calister Lebechukwu Nwadi  1 , Nathaniel Ifeanyi Edeh  2 , Emeka Promise Ugwunwoti  3 , Felicia O Nwokike  3 , Onyinyechi Samuel Nneji  3 , Rose Chigoziri Anamezie  4 , Tracy Obehi Uguru  5 , Franklin Kelechi Onubueze  6 , Peter Ndubuisi Chukwu  6 , Gloria M Eya  3 , Justina Nwabunachi Ikpenwa  7 , Anthony Okorie Nsude  6 , Chibuike Gerald Ozoagu  6 , Chinelo Patricia Aka  6 , Patience Nwobodo  8 , Ijeoma Evelyn Animba  9 , Sussan N Okoli  10
Affiliations
Randomized Controlled Trial

Impact of cognitive-behavioral therapy and mindfulness-based stress reduction in mitigating test anxiety and enhancing academic achievement among vocational education students at Nigerian universities

Calister Lebechukwu Nwadi et al. BMC Med Educ. .

Abstract

Background: The inclusion of behavioral therapy and stress reduction techniques among vocational students of the Nigerian universities is crucial for enhancing their practical skill acquisition and career prospects in challenging academic scenarios. This study explored the combined effects of cognitive-behavioral therapy and mindfulness-based stress reduction in reducing test anxiety among business education students in a measurement and evaluation course.

Methods: Employing a randomized control trial with a pretest-posttest design, the research draws responses from 483 students from two universities in Southeast Nigeria. The participants were randomly assigned to either the treatment or waitlist control groups on the basis of set inclusion criteria. Data collection was conducted via four different instruments, and the treatment group participated in a Cognitive-Behavioral Therapy and Mindfulness-Based Stress Reduction (CBT-MBSR) program. Evaluations of both groups were conducted at three different stages: before the intervention, immediately after the intervention, and during the follow-up period. Analysis was carried out via repeated-measures ANOVA and multivariate analysis of covariance (MANCOVA).

Results: The results indicated that TVET students who underwent the CBT-MBSR intervention had significantly lower post-treatment test anxiety scores than those in the wait-list control group. The intervention also had a significant multivariate effect on reducing test anxiety, improved mindfulness, students' academic achievement, and their well-being (F value = 1168.52 (p =.001, η² = 0.752).

Conclusion: This study assessed the efficacy of CBT with MBSR in reducing test anxiety, improving academic performance, and increasing well-being among students in TVET settings. The study revealed how CBT helped reduce test anxiety, thereby improving students' academic performance through increasing their concentration. Thus, this study provides fresh knowledge on how to improve psychological well-being and educational performance by introducing a new method of combining MBSR and CBT, which enriches the literature with a dual-modality approach that helps students reduce their anxieties and fosters their personal growth. This study has practical implications for university administrators, educators, and researchers and offers several recommendations.

Clinical trial number: Not applicable.

Keywords: Anxiety measurement and evaluation; Cognitive-behavioral therapy; Mindfulness-based stress reduction; Stress; TVET students.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethical approval: for this study was obtained from the Faculty of Vocational and Technical Education, University of Nigeria, with Application ID No: EC/VTE/2024/00093. The study was confined by the ethical standard benchmarks of the American Psychological Association (APA) and the World Medical Association (WMA) (APA, 2007; WMA, 203). This study adhered to the Declaration of Helsinki as we declared that the health and wellbeing of the participants were our first consideration. Consent for publication: Not applicable. Consent to participate: An informed consent form was administered to the participants, who completed the study and returned it to the researchers. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Hypotheses Model. Source: Researchers, 2025 developed using draw.io software
Fig. 2
Fig. 2
Consort flow diagram for population distribution. Adapted from: http://www.consort-statement.org/consort-statement/flow-diagram
Fig. 3
Fig. 3
Mean influence of time on students’ academic anxiety, mindfulness and subjective fitness. Source: Developed using SPSS version 28
Fig. 4
Fig. 4
SEM model Diagram depicting the Academic test Anxiety, Mindfulness and Subjective Fitness of the students before the intervention. Developed by the researchers using SmartPLS 4 Software
Fig. 5
Fig. 5
SEM model Diagram depicting an improved Academic test Anxiety, enhanced Mindfulness and Subjective Fitness of the students after the intervention at Time II. Developed by the researchers using SmartPLS 4 Software
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Abbasi N, Ghosh S. Construction and standardization of examination anxiety scale for adolescent students. Int J Assess Tools Educ. 2020;7(4):522–34. 10.21449/ijate.793084.
    1. Agnes LAS, Muthupandi P. Academic anxiety scale: tool development and validation. Int Educ Res J (IERJ). 2024;10(4). 10.21276/IERJ24671240995766.
    1. Akimov A, Malin M, Sargsyan Y, Suyunov G, Turdaliev S. Student success in a university first-year measurement and evaluation course: do students’ characteristics affect their academic achievement? J Stat Data Sci Educ. 2024;32:24–35.
    1. Akinsola EF, Nwajei AD. Test anxiety, depression and academic performance: assessment and management using relaxation and cognitive restructuring techniques. Psychology. 2013;4(6):18–24.
    1. Anyamene AN, Udeagha FU. (2025). Effect of Cognitive Restructuring Technique on Test Anxiety among Secondary School Students in Anambra State. (2025). Journal of Guidance and Counselling Studies. 9(1):58–69.

Publication types

LinkOut - more resources