Kindness begins with yourself: The role of self-compassion in adolescent body satisfaction and eating pathology

Appearance Comparison, Body Appreciation, and Adolescent Depressive Symptoms: Roles of Gender, Age, and Body-Mass Index

Objective

This study aimed to examine the association between appearance comparison and adolescent depressive symptoms, the mediating role of body appreciation, and the moderating roles of gender and body-mass index (BMI) among adolescents in different age groups.

Methods

A cross-sectional sample of 2645 Chinese students aged 12-16 years (44.7% girls) participated. The measurements included depressive symptoms, appearance comparison, body appreciation, weight, and height. Multigroup path analysis was used to examine the moderated mediation model.

Results

Compared with boys, adolescent girls presented greater levels of appearance, which increased with age. Body appreciation mediated the association between appearance comparison and depressive symptoms in girls, whereas appearance comparison directly correlated with depressive symptoms in boys. Body appreciation decreased with increasing BMI in boys but remained relatively stable in girls. Similar patterns were observed among junior and senior high school students.

Conclusion

This study underscores the significant relationship between appearance comparison and adolescent depressive symptoms, suggesting varied mechanisms based on gender and BMI levels.

Self-compassion and cognitive reappraisal restore female adolescents' body satisfaction and appreciation after appearance-related rumination

Rumination regarding appearance is a major cause of body dissatisfaction among adolescents. Body ‎image concerns in this age group may lead to ‎considerable psychological distress. Studies suggest that adaptive emotion regulation strategies such as cognitive reappraisal and self-compassion can counteract the harmful consequences of rumination. The goal of the current study was to assess if and to what extent cognitive reappraisal and self-compassion can improve female adolescents' body satisfaction and appreciation after engaging in appearance-related rumination. ‎Using an experimental design, 142 healthy female adolescents underwent an appearance-related rumination induction. ‎Following this, participants were randomly allocated to one of three experimental conditions requiring to implement either self-compassion, cognitive reappraisal, or rumination using a writing task. State body dissatisfaction ‎and appreciation were assessed at baseline, post-appearance rumination, and post-‎writing tasks. Appearance-related rumination increased state body dissatisfaction and reduced body appreciation in all groups. Importantly, state body dissatisfaction and appreciation fully restored to their baseline levels after implementing self-compassion and cognitive reappraisal, but not rumination. The findings provide empirical evidence regarding the negative consequences of appearance-related rumination among adolescents and demonstrate how adaptive emotion regulation strategies can assist in coping efficiently with appearance-related rumination.

Embodying loving kindness: Examining self-compassionate writing tasks and body satisfaction among transgender and non-binary people

Using an experimental posttest-only control group design, the purpose of this study was to examine the effects of self-compassionate writing exercises on transgender and non-binary participants' body satisfaction, gender identity pride, and internalized transphobia. A total of 238 transgender people participated in this study (Mage = 28.27, SD = 8.12). Participants were randomly assigned to a self-compassionate writing task focusing on their gender identity, a self-compassionate writing task focusing on their body image as a transgender person (i.e., gendered body image), and a control condition, which required them to write about a neutral day in their lives. Results demonstrated that those in the gendered body image self-compassionate condition reported higher state-level effects of body satisfaction following the intervention than those in the control condition. No significant effects were observed for condition on state-level gender identity pride or internalized transphobia. Results also demonstrated that non-binary participants reported higher levels of gender identity pride than trans femme participants. Exploratory post-hoc analyses revealed that gender identity pride moderated the effect of condition on body satisfaction. Compared to those in the control condition, participants in the gendered body self-compassionate condition with moderate and high levels of gender identity pride reported higher levels of body satisfaction. Results demonstrate potential beneficial effects of brief self-compassionate writing exercises on transgender peoples' body satisfaction.

A network analysis of disordered eating symptoms, big-five personality traits, and psychological distress in Chinese adults

OBJECTIVE

Previous studies have revealed associations between disordered eating symptoms, big-five personality traits, and psychological distress. However, limited research has explored these relationships as a network, including their interconnections, and even less has done so in non-Western populations. We employed network analysis to investigate the co-occurrence of disordered eating symptoms, big-five personality traits, and psychological distress in Chinese adults.

METHOD

A sample of 500 Chinese adults (256 men) completed measures assessing big-five personality traits, psychological distress, and disordered eating symptoms. The network of personality traits, psychological distress, and disordered eating symptoms was estimated, including its central and bridge nodes.

RESULTS

The central nodes in the network were the facets of openness (like adventure), extraversion (like going to social and recreational parties), and disordered eating symptoms (dissatisfaction with body weight or shape). Moreover, certain facets of neuroticism (always worrying something bad will happen), psychological distress (feeling worthless), and an inverse facet of extraversion (bored by parties with lots of people) were identified as essential bridge nodes in maintaining the structure of the network.

CONCLUSION

Our findings suggest that personality traits (e.g., openness and extraversion) and body dissatisfaction are important in maintaining the network in a community sample of Chinese adults. While future replication is needed, findings from this study suggest that individuals with negative self-thinking, predisposed neuroticism, and extraversion may be at risk of developing disordered eating symptoms.

PUBLIC SIGNIFICANCE

The present study contributes to existing knowledge by employing a network perspective to examine the associations between disordered eating symptoms, big-five personality traits, and psychological distress in a Chinese adult community sample. The identified facets of neuroticism and extraversion and symptoms of psychological distress may be worthy of targeting in the prevention and treatment of disordered eating in the Chinese context.

Self-compassion, body satisfaction, and disordered eating symptoms in male collegiate athletes: A longitudinal analysis

Male athletes are a subpopulation at risk for developing eating disorders and disordered eating concerns, primarily due to the presence of socioculturally-based factors, including body dissatisfaction. Self-compassion may alleviate this risk by improving body satisfaction. To date, no study has examined longitudinally self-compassion's effect on body satisfaction and, ultimately, disordered eating in male athletes. Across two time points separated by four months, we assessed self-compassion, body satisfaction, and disordered eating in 454 male collegiate athletes. Through cross-lagged, panel analysis, after controlling for the Time 1 scores, we determined that: (a) Time 1 self-compassion was neither directly related to Time 2 body satisfaction (β = 0.02, p = .755), nor indirectly to Time 2 disordered eating (β = -0.002, 95% BCaCI [-0.028, 0.014]), and (b) Time 1 body satisfaction directly predicted Time 2 disordered eating (β = -0.12, p < 0.05). Our findings extend past research, demonstrating that body satisfaction is a primary antecedent to disordered eating among male athletes. However, the proposed effects of self-compassion on the body satisfaction to disordered eating relationship were not supported and may be dependent on gender and athlete status.

Black adolescents' appearance concerns, depressive symptoms, and self-objectification: Exploring the roles of gender and ethnic-racial identity commitment

There is a dearth of research examining Black adolescents' body image, with even less work examining gender differences or the influence of ethnic-racial identity (ERI) commitment. It is critical to understand how culturally relevant aspects of appearance-beyond commonly measured ideals such as thinness and muscularity-are particularly relevant to Black adolescents. The present study of Black youth (n = 252; 55% girls, 45% boys, ages 13-18, M_age = 15.5) explored the roles of gender and ERI commitment in the associations between skin tone, hair, and facial satisfaction and appearance esteem, depressive symptomatology, and self-objectification. With a few exceptions, satisfaction with skin tone, hair, and face were significantly associated with higher appearance esteem and lower self-objectification and depressive symptoms, even when controlling for weight and muscle tone satisfaction. Findings were similar across genders, with some associations stronger among Black girls relative to boys. Among youth with higher ERI commitment, associations were stronger between skin tone, hair, and facial satisfaction and some indicators of wellbeing. Findings elucidate the role of culturally relevant appearance concerns of Black adolescents and the potential benefits of ERI commitment. This work can inform culturally sensitive research practices and therapeutic interventions related to Black youth's body image experiences.

"Intermission!" A short-term social media fast reduces self-objectification among pre-teen and teen dancers

Social media use is pervasive among youth and is associated with body image disturbance and self-objectification. The present study investigated whether a 3-day social media fast in a sample for whom social media is especially salient, female adolescent dancers, can mitigate such negative effects. Through an online survey, 65 pre-teen and teen girls, aged 10-19, completed measures of self-objectification (body surveillance and body shame), self-esteem and self-compassion both prior to and following three days of abstaining from all social media. During the fast, girls reflected on their experiences in group messages on the messaging app, WhatsApp. Overall, the fast had positive effects on participants, for whom body surveillance and body shame was significantly reduced after the fast. Self-compassion significantly mediated the change in both body surveillance and body shame, and self-esteem was a significant mediator of improvements in body shame. The content of girls' group messages revealed a number of themes, such as more positive mental states during the fast. Future research should continue to examine the potential of brief social media fasts as a means to alleviate appearance pressures adolescent girls face on these platforms in daily life.

Enriching sociocultural perspectives on the effects of idealized body norms: Integrating shame, positive body image, and self-compassion

Body image is an integral aspect of the psychology of the self. Idealized body images are ubiquitous in both traditional media forms (e.g., magazines, television) and social media (e.g., Facebook, Instagram). The classic sociocultural model of body image (i.e., the Tripartite Influence Model) emphasizes pathways between idealized body norms, appearance comparisons, internalization of body ideals, and body dissatisfaction and its outcomes. We summarize the model and identify some issues to be addressed in future work, particularly in light of the immense popularity of social media. We review three topics that are not included in the sociocultural model but that provide a more complete picture of the influence of societal body norms on body image: (1) body shame, (2) positive body image, and (3) self-compassion. Research on the nature, assessment, and relevance of these constructs is reviewed in detail. In terms of clinical applications of these areas of research for individuals at risk of body dissatisfaction, we suggest assessing for and targeting body shame, cultivating facets of positive body image, and teaching strategies for developing self-compassion.

The moderating role of self-compassion on the relationship between emotion-focused impulsivity and dietary restraint in a diverse undergraduate sample

OBJECTIVE

High levels of emotion-focused impulsivity (e.g., negative urgency) are significantly related to disordered eating behaviors, including dietary restraint. The objective of the current study was to understand the moderating role of self-compassion between emotion-focused impulsivity and dietary restraint in a diverse undergraduate sample. We hypothesized that high levels of self-compassion would protect individuals with high levels of emotion-focused impulsivity from engaging in high levels of dietary restraint.

METHOD

Participants (n = 607, M_age = 18.8, 63 % female, 45.3 % White) completed the UPPS-P, Eating Disorder Examination Questionnaire, and the Self-Compassion Questionnaire as part of a larger study examining eating behaviors in college students.

RESULTS

Negative urgency, but not positive urgency, was related to dietary restraint. Self-compassion moderated the relationship between both forms of impulsivity and dietary restraint, such that individuals with high emotion-focused impulsivity and high self-compassion had lower dietary restraint than individuals who had high emotion-focused impulsivity and low self-compassion.

DISCUSSION

Emotion-focused urgency is a risk factor for dietary restraint; both factors are highly correlated with more severe eating pathology, such as binging and purging behaviors. Self-compassion may buffer against the risk of emotion-focused impulsivity on engaging in dietary restraint behaviors in a community sample, which may inform our understanding of preventative interventions against eating pathology. These results should be replicated in clinical populations and across eating disorder diagnoses.

A Retrospective Literature Review of Eating Disorder Research (1990–2021): Application of Bibliometrics and Topical Trends

Despite the growing importance of eating disorders in society and academic literature, only a few bibliometric review studies using bibliometric analysis were available. Hence, this study aimed to explore and uncover hidden research topics and patterns in articles in terms of eating disorders over the last 30 years. In total, 4111 articles on eating disorders were analyzed using bibliometrics, network analyses, and structural topic modeling as the basis of mixed methods. In addition to general statistics about the journal, several key research topics, such as eating disorder (ED) treatment, ED symptoms, factors triggering ED, family related factors, eating behaviors, and social factors, were found based on topic correlations. This study found the key research variables that are frequently studied with EDs, such as AN, BN, BED, and ARFID. This study may help clinicians comprehend important risk factors associated with EDs. Moreover, the findings about key ED research topics and their association can be helpful for future studies to construct a comprehensive ED research framework. To our knowledge, this is the first study to use topic modeling in an academic journal on EDs and examine the diversity in ED research over 30 years of published research.

Adolescent girls' body appreciation: influences of compassion and social safeness, and association with disordered eating

PURPOSE

Adolescence has been stated as a period in which body image and eating difficulties' have its greatest expression, especially in females. Nonetheless, protective factors, such as body appreciation and compassion, are not thoroughly studied in this developmental stage. The current study hypothesized that competences for self-compassion and receiving others' compassion associate positively with social safeness, and the three variables with body appreciation. Moreover, the association between body appreciation and disordered eating was analysed. A sample of Portuguese female adolescents was used.

METHODS

205 participants, aged between 12 and 18, completed a set of self-report measures in the school context. Data were explored via descriptive, correlational and path analysis.

RESULTS

Path analysis indicated that self-compassion and receiving compassion from others associate positively with feelings of social safeness which, in turn, associate with higher body appreciation. All the variables in study associated indirectly and negatively with disordered eating, and body appreciation presented a direct and negative association with disordered eating.

CONCLUSION

Findings of the current study may suggest the pertinence of developing programs for female adolescents that include the cultivation of compassionate and affiliative skills to promote positive body image and to prevent or intervene with disordered eating symptoms, with potential effects on overall well-being and mental health.

LEVEL OF EVIDENCE

Cross-sectional descriptive study, Level V.

Self-Compassion Moderates the Association Between Body Dissatisfaction and Suicidal Ideation in Adolescents: A Cross-Sectional Study

Identifying risk and protective factors for suicidal ideation during adolescence is essential for suicide prevention. One potential risk factor is body dissatisfaction which appears to peak during adolescence. The present study investigated the self-compassion buffering effects in the relationship between body dissatisfaction and suicidal ideation. A convenience sample comprising 580 adolescents (mean age 16.35 years; SD = .87; range 14-18 years) was recruited from public schools. The results indicated a strong positive association between body dissatisfaction and suicidal ideation (Cohen's f 2 = .25). The association was significantly moderated by the self-compassion (β =  - .16, SE = .04, p = .01, t  = 2.4.34, .95% CI [- .16, - .01]). Structural equation modeling analysis showed that the lack of self-kindness was associated with a moderate suicidal ideation level (Cohen's f 2 = .14). Also, higher levels of self-judgment predicted suicidal ideation with a moderate to large effect size (Cohen's f 2 = .28). The findings suggest that therapeutic programs designed to develop self-compassion should be implemented to reduce the risk of suicidal ideation among adolescents with body dissatisfaction. The findings empirically show that a higher degree of self-judgment is strongly associated with suicidal thoughts among adolescents, which must be systematically addressed in clinical studies on suicidal risk.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11469-021-00727-4.

Feel Good, Eat Better: The Role of Self-Compassion and Body Esteem in Mothers' Healthy Eating Behaviours

Mothers’ eating behaviours are important to ensure the health and well-being of themselves and their families. Recent research has pointed to self-compassion, defined as extending kindness to oneself in times of perceived inadequacy or general suffering, as a trait associated with healthy forms of eating, such as intuitive eating, and reduced maladaptive forms of eating, such as emotional eating. However, little is known about the psychological mechanism through which self-compassion relates to healthy eating behaviours. This study examined 100 mothers’ levels of self-compassion, body esteem and eating behaviours. Structural equation modelling revealed that self-compassion was positively associated with diet quality and intuitive eating, while being negatively associated with emotional eating. Moreover, these links occurred, in part, due to higher body esteem. This points to a mechanism through which self-compassion may positively contribute to mothers’ healthy eating behaviours. The implications for eating outcomes and women’s health are discussed.

Adjusting Identities When Times Change: The Role of Self-Compassion

Adjusting identity standards may be preferable to relentless pursuit or abandonment of an identity when facing an identity-challenging life transition. Self-compassion (SC) can help people adjust to challenges. The authors examined whether SC was associated with identity adjustment, exercise, and the moderating effect of identity-behavior discrepancy in 279 women exercisers who reported reduced exercise in motherhood. Participants completed the Self-Compassion Scale and reported the extent of and reflected on their identity discrepant behavior (reduced exercise). Reactions to discrepancy (acceptance, shame, guilt, and rumination), correlates of identity adjustment (subjective well-being, autonomous motivation, controlled motivation, and role conflict), and exercise behavior were assessed. SC associated positively with acceptance, correlates of successful identity adjustment, and exercise behavior. SC associated negatively with shame, rumination, and correlates of unsuccessful adjustment. SC may help exercise-identifying women who exercise less after becoming mothers adaptively cope with this identity challenge and continue exercising.

Determining the potential links of self-compassion with eating pathology and body image among women and men: A cross-sectional mediational study

This study examined whether rumination, shame, self-criticism, and perfectionism mediate the previously established link between self-compassion and both eating and body image concerns. A cross-sectional online survey was completed by a community sample of non-clinical adult women (n = 369) and men (n = 201). Participants completed standardised measures of self-compassion (predictor), rumination, external shame, perfectionism and self-criticism (mediating variables), and eating pathology and body image (criterion variables). Path analyses confirmed that higher self-compassion was serially linked to lower eating pathology and body dissatisfaction through comparative self-criticism and external shame. Compared with women, the association between higher self-compassion and lower body dissatisfaction was weaker in men. However, there were no mediating effects of rumination, perfectionism, or internalized self-criticism. Overall results indicate notable similarities between women and men, and emphasise the potential value of targeting external shame during eating disorder prevention and treatment. Longitudinal study of these constructs is warranted in future research.

How is Trait Self-Compassion Used During Appearance-Related Distress by Late Adolescents and Emerging Adults With Positive or Negative Body Image? A Qualitative Study

Having a positive body image contributes to adolescents’ and emerging adults’ psychological well-being. One approach to protecting one’s body image from appearance threats involves adopting a self-compassionate perspective. This study explored how six different facets of trait self-compassion are used by late adolescents and emerging adults to cope with appearance-related distress. Following Institutional Review Board approval, in-depth interviews were conducted with 16 female and 14 male undergraduates ( Mage = 18.77 years, SD = 1.77 years) who reported either positive or negative body image and high or low self-compassion. Adopting a descriptive/confirmative approach, data were analyzed via an a priori coding system based on the six facets of self-compassion. Only one self-compassion facet, self-kindness, was reportedly used to counteract body-related distress, and only by those with a positive body image. Most participants with negative body image engaged in self-judgment, with some expressing a fear of self-kindness. Despite being acknowledged by all, the facet of common humanity was not used for appearance-related affect regulation. Participants showed limited practice of the mindfulness facet. Together, the findings show that scope remains for achieving reductions in body image distress, and corresponding gains in resilience, through self-compassion interventions.

The Norwegian healthy body image intervention promotes positive embodiment through improved self-esteem

We examined both direct and indirect effects of the Healthy Body Image (HBI) intervention on positive embodiment among Norwegian high school students. In total, 2446 12th grade boys (43 %) and girls (mean age 16.8 years) from 30 schools participated in a cluster-randomized controlled study with the HBI intervention and a control condition as the study arms. We tested mediation models using path analysis and found that among several hypothesized mediators, only self-esteem mediated a positive intervention effect on positive embodiment for both boys and girls. A direct effect of the intervention on positive embodiment was only found in girls. The study provides novel findings indicating that health promotion interventions to address a positive embodiment should focus on enhancing adolescent's self-esteem. Serial mediation modeling might reveal more complex explanations of change mechanisms and could further evolve current knowledge.

Transdiagnostic vulnerability factors in eating disorders: A network analysis

OBJECTIVE

Eating disorder (ED) symptoms and transdiagnostic vulnerability characteristics play a crucial role in the aetiology and maintenance of EDs. Over the last decade, researchers have started to model complex interrelations between symptoms using network models, but the literature is limited in that it has focused solely on symptoms and investigated-specific disorders while ignoring transdiagnostic aspects of mental health.

METHOD

This study tackles these challenges by investigating network relations among core ED symptoms, comorbid clinical symptoms (depression and anxiety) and empirically supported vulnerability and protective mechanisms (personality traits, maladaptive cognitive schemata, perfectionism and resilience) in a sample of 2302 treatment-seeking ED patients. We estimated a regularized partial correlation network to obtain conditional dependence relations among all variables. We estimated node centrality (interconnectivity) and node predictability (the overall magnitude of symptom inter-relationships).

RESULTS

The findings indicate a central role of overvigilance, excessive focus on inhibiting emotions and feelings, interoceptive awareness and perfectionism.

CONCLUSIONS

These results suggest that excessive control of bodily aspects by dietary restraint (possibly through inhibition) and interoceptive awareness may be important constructs that warrant future research in understanding vulnerability in EDs. We provide all code and data via the Open Science Framework.

A longitudinal examination of body-checking behaviors and eating disorder pathology in a community sample of adolescent males and females

OBJECTIVE

Related to the cognitive-behavioral theory of eating disorders, body checking has gained increasing recognition as both a maintaining factor for eating disorders and an important target for treatment. However, it is unclear whether body-checking behaviors contribute to the development of disordered eating, or if these behaviors develop as a response to experiencing eating disorder thoughts and behaviors. This study aims to examine the relationships between body-checking behaviors and eating disordered thoughts and behaviors in adolescent females and males in the community over time.

METHODS

Participants included 238 adolescents (n = 104 males, n = 134 females, M_age = 16.5 years) recruited from high schools in British Columbia, Canada, who completed the Eating Disorder Examination Questionnaire and Body Checking Questionnaire at baseline (T1) and again approximately 4 months later (T2).

RESULTS

After controlling for baseline levels of eating pathology and body mass index (BMI), body checking at T1 predicted increases in eating pathology for both males and females. In contrast, after controlling for baseline levels of body checking and BMI, eating pathology at T1 did not predict changes in body checking for females, but it did for males. Findings suggest that, among adolescents, engaging in body-checking behaviors may increase risk for disordered eating.

DISCUSSION

If supported by further research, targeting body-checking behaviors in prevention programs may be warranted.

Is self-compassion relevant to the pathology and treatment of eating and body image concerns? A systematic review and meta-analysis

Eating disorders are severe mental health conditions, with substantial consequences for health and quality of life. Such disorders are strongly associated with body image concerns. It is important to consider treatments that might enhance our ability to treat such cases. Recently, there has been a growing body of research on self-compassion in relation to such problems. However, we are not yet clear about the extent of such effects, given the range of studies and methodologies used. Therefore, a systematic literature review was carried out using four key databases. Meta-analysis was used to reach conclusions about the size of the effects and moderators. Random-effects meta-analyses were conducted with 59 studies. Higher self-compassion was associated with lower eating pathology, reduced body image concerns, and greater positive body image, with medium to strong effect sizes (respectively, r = -0.34, r = -0.45, r = 0.52). Furthermore, self-compassion interventions for eating pathology and body image were effective, and superior to control groups (respectively, g = 0.58, g = 0.39). These findings support the role of self-compassion in understanding and addressing eating and body image concerns. Self-compassion appears to be an adaptive emotion regulation strategy in eating disorders and body image.

Most women with anorexia nervosa report less eating pathology on days when they are more self-compassionate than usual

OBJECTIVE

Individuals with eating disorders who have lower trait levels of self-compassion have more severe eating pathology. This study examined the extent to which levels of self-compassion fluctuate day-to-day in individuals with anorexia nervosa (AN) and whether these fluctuations contribute to their eating pathology.

METHOD

For 2 weeks, 33 women with typical (75%) and atypical AN reported on their daily eating pathology and self-compassion.

RESULTS

Nearly half the variance in participants' self-compassion scores occurred at the within-persons daily level. Multilevel modeling revealed that on days when participants were more self-compassionate than usual, their eating pathology was lower. However, this effect was moderated by participants' mean self-compassion level over the 2 weeks. Specifically, daily self-compassion was negatively related to eating pathology among individuals with average and higher mean self-compassion levels but was not related to eating pathology among those with lower levels.

DISCUSSION

One-time self-reports of self-compassion in individuals with AN may overlook the substantial within-person variability in their self-compassion levels. For most individuals with AN, responding to distressing daily experiences with more compassion than usual should be associated with decreased eating pathology. More work is needed to understand how individuals lower in dispositional self-compassion can benefit from these upward fluctuations.

Well-Being Workshops in Eating Disorder Wards and Their Perceived Benefits to Patients and the Multi-Disciplinary Team: A Pilot Study

A more holistic definition of patients' recovery from eating disorders (EDs) highlights that well-being interventions linked to self-compassion are under-researched and under-utilised. Staff burnout is also common in ED units (EDUs), linked to difficult relationships with patients and poor self-care, and is not well addressed. Therefore we piloted a series of joint well-being workshops to target these issues. Joint workshops were offered to patients (n = 55) and the multi-disciplinary team MDT (n = 34) in adult ED wards over two years. Experiences were evaluated quantitively and qualitatively. Mood post-workshops increased significantly for both groups (patients: p < 0.001, r = 0.49; MDT: z = 3.043, p = 0.002, r = 0.41), with the feeling that they deserved to take time for self-care (patients: z = 2.419, p = 0.016, r = 0.31); MDT: z = 2.814, p = 0.005, r = 0.38). Workshops were found to be enjoyable and highly relevant to well-being, but less useful by patients. Thematic analysis identified six themes: Enjoyment, recovery and well-being, relationships, content, structure and future ideas. Both groups experienced improved mood and increased enjoyment and awareness of well-being. Patient isolation was addressed, and the staff experienced stress reduction and increased productivity. Both groups experienced improved relationships.