ATT has been tested in several student samples. Two studies in university students are especially relevant to anxiety, depression, stress and meta-worry — and reading them carefully says something more specific than “it works”.
The two studies
Haukaas and colleagues (2018) randomized 81 Norwegian university students with self-reported symptoms of depression, anxiety or stress into ATT or Mindful Self-Compassion, three group sessions over three weeks, with six-month follow-up[1].
Myhr and colleagues (2019) ran 46 students who identified as currently stressed — 23 doing ATT, 23 on a wait-list — over four weeks, measuring stress appraisals and meta-worry[2].
What they found
| Study | Comparison | Result |
|---|---|---|
| Haukaas 2018[1] | Mindful Self-Compassion | Both groups showed significant reductions in anxiety and depression, with no significant difference between conditions |
| Myhr 2019[2] | Wait-list | Stress appraisals and meta-worry “decreased significantly following ATT with large pre- to post- effect sizes but there were minimal changes in the control group” |
Two honest observations about that table.
ATT did not outperform the alternative. In the 2018 trial it matched Mindful Self-Compassion rather than beating it. Anyone citing that study as showing ATT is better than mindfulness is misreading it.
A wait-list is a weak comparison. The 2019 study’s control group did nothing at all, so its large effects include everything that comes with doing something — expectancy, attention from researchers, the passage of four weeks. It is a real result and a soft one.
The finding that is actually distinctive
Buried in the 2018 trial is the most interesting sentence in this literature for anyone choosing between practices: improvement in attention flexibility was the only significant unique predictor of treatment response[1].
That does not demonstrate what caused the change. A predictor can identify who improved without establishing a mechanism or mediation pathway. It is nevertheless consistent with what the technique says it is for: Wells describes ATT as aiming to directly modify the control of attention and improve flexible executive control[3].
Both groups improved; the students whose attentional flexibility improved were the ones who responded, whichever practice they had been given.
What was not measured
Worth stating plainly, because it is the thing students actually want to know: neither study measured studying. No academic performance, no coursework concentration, no exam outcomes. Whether ATT transfers to sitting down with a reading list is not answered by these trials or by anything else published — the transfer problem is covered on attention training for focus.
The dose in these studies is also modest by the protocol’s standards: three group sessions over three weeks[1], against a manual that asks for twice-daily practice while noting most people manage once[3].
What to take from it
If you are a stressed student deciding whether to try this: the evidence says a short course of ATT has been associated with reduced anxiety, depression and stress appraisals in student samples. It did not outperform Mindful Self-Compassion in one trial; it did outperform a wait-list on selected outcomes in another. Improvement in attentional flexibility predicted response in the 2018 trial, but that does not prove it caused the response.
That is a more useful and more honest summary than any headline. And it is still students in trials, not you at your desk in week nine.
If low mood or anxiety is affecting your studies seriously, most universities have a counselling service, and that is the right first call rather than an app.
Questions and answers
- Has ATT been tested on students?
- Yes. A 2018 randomized trial compared it with Mindful Self-Compassion in 81 university students, and a 2019 controlled study compared it with a wait-list in 46 stressed students.
- Did it beat the alternative?
- It did not beat Mindful Self-Compassion in the 2018 trial. In the 2019 study, ATT produced larger changes than a wait-list on perceived stress and meta-worry frequency, but a wait-list is a weaker comparison than an active intervention.
- Will it help me study?
- That was not measured. Neither trial tested academic performance or studying, and no published study answers whether ATT transfers to concentration on coursework.
References
- Haukaas, R. B., Gjerde, I. B., Varting, G., Hallan, H. E., & Solem, S. (2018). A randomized controlled trial comparing the attention training technique and mindful self-compassion for students with symptoms of depression and anxiety. Frontiers in Psychology, 9, 827. https://pmc.ncbi.nlm.nih.gov/articles/PMC5982936/
- Myhr, P., Hursti, T., Emanuelsson, K., Löfgren, E., & Hjemdal, O. (2019). Can the attention training technique reduce stress in students? A controlled study of stress appraisals and meta-worry. Frontiers in Psychology, 10, 1532. https://pmc.ncbi.nlm.nih.gov/articles/PMC6635479/
- Wells, A. (2009). Metacognitive Therapy for Anxiety and Depression. Guilford Press. Chapter 4: Attention Training Techniques.
Published by the makers of Heed, an app for practicing ATT-style sessions. iPhone · Android. Heed is a self-practice tool inspired by ATT research — not therapy, and not a medical device.