Randomised controlled trial of the new short-term online emotion focused training for self-compassion and self-protection in a nonclinical sample

Longitudinal Serial Mediation Relationship of Intolerance of Uncertainty, Irrational Happiness Beliefs and Mistake Rumination with Family Communication

The family systems approach suggests that individuals' psychological processes are shaped within the framework of family interactions. Accordingly, the current study examines the long-term effects of intolerance of uncertainty, irrational happiness beliefs and mistake rumination on family communication within the scope of a semi-longitudinal model. The study analyzed the predictive power of intolerance of uncertainty on irrational happiness beliefs and mistake rumination and whether these variables play a mediating role in family communication. The study, which was conducted in two phases at five-month intervals, included 325 adult participants aged 18-51. Longitudinal serial mediation analysis revealed that intolerance of uncertainty increases irrational happiness beliefs and mistake rumination over time, and these processes negatively affect family communication. The findings suggest that individuals' low tolerance for uncertainty may shape long-term psychological and relational dynamics through family interactions. The study emphasizes the importance of holistic interventions to support the functionality of family systems. In particular, it is suggested that short-term systemic family therapy and emotion-focused individual interventions may be effective in strengthening family communication and increasing the psychological resilience of individuals.

Developing Self-Compassion in Healthcare Professionals Utilising a Brief Online Intervention: A Randomised Waitlist Control Trial

(1) Background: The level of stress experienced by staff in the healthcare sector is highly prevalent and well documented. Self-compassion may support the health and wellbeing of individuals and enable them to stay well at work. This study aimed to understand whether a brief, online, self-guided, novel intervention improved the health and wellbeing of healthcare professionals. (2) Methods: In a parallel randomised controlled trial, a volunteer sample of healthcare professionals were assigned to an intervention group (n = 110) or a waitlist control group (n = 80). Measures of self-compassion, mental wellbeing, stress and burnout were collected by an online questionnaire at baseline, post-programme and, for the intervention group, at follow-up. (3) Results: This intervention appeared to be effective in increasing self-compassion and mental health and decreasing stress and burnout. Significant group effects and significant time × group interactions for overall self-compassion [F (2, 183) = 32.72, p < 0.001; effect size ηp2 = 0.226], mental wellbeing [F (2, 212) = 17.46, p < 0.001; effect size ηp2 = 0.135], perceived stress [F (2, 205) = 5.42, p = 0.006; effect size ηp2 = 0.46], personal burnout [F (2, 224) = 7.57, p = 0.001; effect size ηp2 = 0.063] and work burnout [F (2, 208) = 7.39, p = 0.001; effect size ηp2 = 0.062] were found. (4) Conclusions: This study shows promise that an affordable and scalable intervention can be effective for busy healthcare professionals operating in a significantly challenging environment.

Role of self-criticism in postpartum mental health: a network analysis

PURPOSE

A significant percentage of women experience psychopathological symptoms during the postpartum period, which can impact not only their mental health and well-being but also the relationship between mother and baby. However, studies investigating how specific psychological factors, such as self-compassion and self-criticism, contribute to the development and maintenance of these symptoms are scarce.

METHODS

This cross-sectional study aimed to examine the relationship among compassionate self-responding (CSR), uncompassionate self-responding (USR), maternal mental health indicators, mother-infant bonding, and the perceived impact of the COVID-19 pandemic. Data were collected online from 189 Brazilian women with infants aged 0 to 12 months. Participants completed measures of sociodemographic characteristics, Self-Compassion Scale (SCS), Edinburgh Postnatal Depression Scale (EPDS), Postpartum Specific Anxiety Scale (PSAS-BR-RSF-C), Postpartum Bonding Questionnaire (PBQ), and COVID-19-Impact on Quality of Life (COV19-QoL).

RESULTS

Through network analysis, our findings highlighted that postpartum depression played a central role in the structuring of variables in this system. Furthermore, USR, instead of CSR, emerged as the variable most strongly associated with levels of postpartum depression, which, in turn, was associated with mother-infant bonding.

CONCLUSION

Mitigating levels of self-criticism in mothers may represent a pathway to prevent the development of postpartum depression, which, in turn, could impact the quality of the mother-infant relationship. Given the significance of the child's early years for their emotional development, intervening early in maternal mental health may be a means to prevent mental disorders in the child as well.

Application of Positive Psychology in Digital Interventions for Children, Adolescents, and Young Adults: Systematic Review and Meta-Analysis of Controlled Trials

BACKGROUND

The rising prevalence of mental health issues in children, adolescents, and young adults has become an escalating public health issue, impacting approximately 10%-20% of young people on a global scale. Positive psychology interventions (PPIs) can act as powerful mental health promotion tools to reach wide-ranging audiences that might otherwise be challenging to access. This increased access would enable prevention of mental disorders and promotion of widespread well-being by enhancing self-efficacy, thereby supporting the achievement of tangible objectives.

OBJECTIVE

We aimed to conduct a comprehensive synthesis of all randomized controlled trials and controlled trials involving children, adolescents, and young adults, encompassing both clinical and nonclinical populations, to comprehensively evaluate the effectiveness of digital PPIs in this age group.

METHODS

After a literature search in 9 electronic databases until January 12, 2023, and gray literature until April 2023, we carried out a systematic review of 35 articles, of which 18 (51%) provided data for the meta-analysis. We included randomized controlled trials and controlled trials mainly based on web-based, digital, or smartphone-based interventions using a positive psychology framework as the main component. Studies included participants with a mean age of <35 years. Outcomes of PPIs were classified into indicators of well-being (compassion, life satisfaction, optimism, happiness, resilience, emotion regulation and emotion awareness, hope, mindfulness, purpose, quality of life, gratitude, empathy, forgiveness, motivation, and kindness) and ill-being (depression, anxiety, stress, loneliness, and burnout). PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used for the selection of studies and data extraction. Quality assessment was performed following the CONSORT (Consolidated Standards of Reporting Trials) guidelines.

RESULTS

For well-being outcomes, meta-analytic results showed that PPIs augmented the feeling of purpose, gratitude, and hope (Hedges g=0.555), compassion (Hedges g=0.447), positive coping behaviors (Hedges g=0.421), body image-related outcomes (Hedges g=0.238), and positive mindset predisposition (Hedges g=0.304). For ill-being outcomes, PPIs reduced cognitive biases (Hedges g=-0.637), negative emotions and mood (Hedges g=-0.369), and stress levels (Hedges g=-0.342). Of note, larger effect sizes were found when a waiting list control group was considered versus a digital control group. A funnel plot showed no publication bias. Meta-regression analyses showed that PPIs tended to show a larger effect size on well-being outcomes in studies including young adults, whereas no specific effect was found for ill-being outcomes.

CONCLUSIONS

Revised evidence suggests that PPIs benefit young people's well-being and mitigate ill-being symptoms. Digital platforms offer a unique way to address their mental health challenges, although not without limitations. Future research should explore how they work for the needs of the young population and further examine what specific PPIs or combination of interventions is most beneficial with respect to other digital control groups.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42023420092; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=420092.

The association between maternal parenting perceived by early childhood teachers and burnout: the mediating effect of self-compassion and teacher efficacy

Given the increasing importance of early childhood teachers, this study aims to identify whether past maternal parenting is related to burnout through the double mediation of teacher self-compassion and teacher efficacy, using model comparison. To this end, a survey was conducted with 329 early childhood teachers in Korea. The positive maternal parenting perceived by teachers was negatively related to burnout through teachers' self-compassion and efficacy. Positive maternal parenting reduced burnout by increasing self-compassion and consequently teacher efficacy. Teachers' self-compassion was more closely related to burnout than teacher efficacy, which was treated as an important variable in relation to teachers. These results suggest that early childhood teachers' self-compassion is a significant variable in relation to burnout and suggestions are provided for specific support programs to promote teacher self-compassion.

Randomized controlled trial of emotion-focused training for helping professionals

Introduction

The aim of this study was to examine the short- and long-term effectiveness of the novel Emotion-focused Training for Helping Professions on levels of compassion fatigue (secondary traumatic stress & burnout), self-criticism, self-compassion, and compassion for others.

Methods

A randomized controlled trial study was conducted. A total of 253 participants were recruited and randomly assigned to either the experimental group or the control group. The experimental group attended a 14-day online training. The control group did not perform any tasks.

Results

Results showed that after completing the intervention the experimental group participants reported significantly lower scores for secondary traumatic stress, burnout and self-criticism, and higher scores for self-compassion and that these lasted for two months after completion. Compared to the control group, the experimental group participants had significantly lower scores of secondary traumatic stress, burnout, self-criticism, and higher scores of self-compassion after the intervention. No significant changes were found for the control group, except a significant increase in time in the reported score for one dimension of burnout - exhaustion.

Discussion

The novel EFT-HP training was shown to be effective in reducing levels of compassion fatigue (secondary traumatic stress and burnout) and self-criticism and increasing self-compassion.

Emotion-Focused Mobile App for Promoting Self-Compassion, Self-Protection, and Self-Criticism

The COVID-19 pandemic has changed our daily lives and restricted access to traditional psychological interventions. Hence there is an immediate and growing demand for accessible and scalable mental health solutions. Emotion-focused training for self-compassion and self-protection was developed and distributed using mobile phone technologies, and its effectiveness was tested. The available research sample consisted of 97 participants with a mean age of 26.06 years and a standard deviation of 10.53. Participants using the mobile app underwent a 14-day program aimed at reducing self-criticism while increasing self-compassion and self-protection. Pre- and post-measurements were collected. The results showed a statistically significant medium effect on self-compassion, self-criticism, and self-protection performance and a significant small effect on self-protection distress. The finding that a 14-day mobile app was able to foster well-being in the form of self-compassion, self-protection, and self-criticism is promising. It indicates the potential for individuals to obtain help through the use of remote tools such as MHapps for a fraction of the usual cost, at their own pace, and without other restrictions.

Qualitative Analysis of Chair Tasks in Emotion-Focused Therapy Video Sessions

One of the key elements of Emotion-Focused Therapy (EFT) is decreasing self-criticism as a secondary, maladaptive emotion within two-chair interventions while simultaneously increasing self-compassion and self-protection as primary, adaptive emotions. Though the concepts of self-compassion, self-protection, and self-criticism are highly acknowledged within psychotherapy research, the verbal articulation of these constructs within therapy sessions is underinvestigated. Thus, this qualitative study aims to examine how self-criticism, self-protection, and self-compassion are articulated by clients in EFT video sessions. Consensual qualitative research was used for data analysis performed by two core team members and one auditor. Three similar domains were considered for all three concepts: behavioural, emotional, and cognitive aspects. The number of self-protection statements was the highest among the states. The behavioural aspect was the most dominant domain for self-protection with the major subdomain 'I tell you what I need'. For self-compassion, the cognitive aspect was the most significant domain containing eight subdomains, such as 'I see your bad circumstances'. The most frequent domain for self-criticism was the behavioural aspect consisting of the two subdomains 'I point out your wrong behaviours and I give you instructions'. The findings demonstrate the significance of promoting both self-compassion and self-protection to combat self-criticism. More studies of categorising a broader number of cases among various therapy approaches are necessary to develop a more detailed understanding of clients' verbalisation of self-compassion, self-protection, and self-criticism within therapy.

A WeChat-based self-compassion training to improve the treatment adherence of patients with schizophrenia in China: Protocol for a randomized controlled trial

Background

At present, adherence to antipsychotic treatment is often poor, leading to the recurrence of symptoms. This increases the likelihood of the patient experiencing disability and thus increases the disease burden for the patient, their family, and society as a whole. However, to date, there is no clear evidence regarding the effect of medication adherence interventions on outcomes for patients with schizophrenia. Moreover, the traditional intervention methods are limited by manpower and resources in low- and middle-income countries. Recent studies have demonstrated that increasing a patient’s level of self-compassion may improve their treatment adherence. Online mental health care interventions have advantages in terms of feasibility and acceptability for patients with schizophrenia. In this regard, a WeChat-based self-compassion training protocol to improve patient treatment adherence was designed in this study and will be evaluated in the future to determine its impact on patients with schizophrenia.

Methods

The protocol for the randomized controlled trial (RCT) is based on the SPIRIT 2013 statement. This parallel RCT will aim to recruit 392 patients with schizophrenia who will be randomized at a 1:1 ratio into a 3-week intervention or control group. Both groups will receive routine care. The intervention group will also receive WeChat-based self-compassion training, which requires participants to complete three tasks every day, including a reading task, a meditation task, and a self-compassion journal task. The control group will receive WeChat-based psychological health education, which will only require participants to read positive articles about psychological health every day. Medication adherence, self-compassion, stigma, and social support will be measured at baseline (T0), immediately after the intervention (T1), and 3 weeks after the intervention (T2). Program feasibility will be evaluated throughout the course of the study, and acceptability will be measured immediately after the intervention (T1).

Expected results:

The intervention described here will address the barriers to accessing mental health care for people with schizophrenia, including patients’ desire for independent management, difficulty accessing providers, and concerns about privacy and stigma. The current study provides guidance for clinical nurses to carry out psychological intervention, with the ultimate aim of addressing the problems associated with a shortage of psychological professionals in low- and middle-income countries.

"Effectiveness of Emotion Focused Training for Self-Compassion and Self-Protection in Individuals with Increased Narcissism"

"Objective: The goal of the study was to map out the effectiveness of a 14-day online intervention (EFT-SCP) focused on self-compassion and self-protection in people with an increased level of narcissism. Method: The research sample consisted of 63 participants, 19 men and 44 women, aged 21 to 70 years (M = 32.49; SD = 15.73). Participants were randomly assigned to intervention group (N = 32) or to the passive control group (N = 31). Results: The results indicate that the self-compassion level in the experimental group did not increase following the intervention. However, the same group scored significantly lower on self-criticism after taking part in the intervention. Conclusion: Short term online intervention was able to decrease self-criticism in subclinical population with increased traits of narcissism but was not effective in increasing self-compassion. It seems that in individuals with increased narcissism, it could take longer to develop kind and warm feelings towards self, connected to self-compassion. The process of decreasing self-criticism was effective and could be the starting point for further cultivating of self."

Emotion-focused group therapy among women with premenstrual dysphoric disorder: A randomized clinical trial

OBJECTIVE

Premenstrual Dysphoric Disorder (PMDD) contributes to couple burnout, reduced quality of life, sexual dysfunction, and social isolation. The present study aimed to investigate the effectiveness of emotion-focused group therapy (EFGT) in pain perception, self-compassion, sexual function, and couple burnout in women with PMDD. Method: Among married females with PMDD, 72 participants were selected and randomly assigned to experimental and waitlist control groups. EFGT was performed in 10 sessions for the subjects in the experimental groups. The McGill Pain Questionnaire, Self-Compassion Scale, Female Sexual Function Index and Couple Burnout Measure were used to collect data in the pre-test and post-test. To analyze the data, an analysis of covariance test was applied. Results: The findings demonstrated that EFGT was effective in pain perception (p < .001, η²=.80), self-compassion (p < .001, η²= .86), sexual function (p < .001, η²= .38), and couple burnout (p < .001, η²= .70). Participants of EFGT improved well, were satisfied with treatment, and had a good therapeutic relationship. Conclusion: Implementing EFGT increased the components of self-compassion and sexual function, and reduced the components of pain perception and couple burnout. It seems that EFGT could be effective in women with PMDD.

Increasing access to pain management: Feasibility of a self-compassion psychoeducational website using a minimally monitored delivery model

Self-compassion has been associated with several positive pain-related outcomes. However, little is known about the impact of targeting self-compassion on pain management. This study assesses the feasibility of a self-compassion psychoeducation website among adults with chronic pain using a minimally monitored delivery model. Participants (N = 26) were recruited online and a single group pre-test and post-test design with a 3-month follow-up was used. The intervention was a 6-week program comprised of a video, writing exercises, guided meditations and automated emails. Feasibility outcome measures were grouped into the following categories: study engagement (ease of recruitment, attrition, adherence, satisfaction), pain vulnerability variables (intensity, interference, catastrophizing, mood) and protective pain variables (self-compassion, resilience and acceptance). Challenges pertaining to uptake were encountered. Attrition was higher (n = 11/26; 42%) and adherence to the full treatment protocol lower (n = 6/26; 23%) than expected. Treatment satisfaction was high with nearly all study completers (93%) reporting that they would recommend the program to a friend. Intent-to-treat mixed effects models showed a significant and large increase of self-compassion (d = 0.92) and a significant impact on several outcome variables (ds from 0.24 to 1.15) with most gains either maintained or increased at follow-up. The recruitment strategy may have negatively impacted participant engagement. Methodological modifications are proposed to improve the feasibility of the program. Minimally monitored web-based programs targeting self-compassion may benefit adults with chronic pain who may have limited access to traditional psychological services or who prefer online-based interventions.

Self-compassion and the Mitigation of Negative Affect in the Era of Social Distancing

Objectives

The outbreak of contagious diseases and their associated non-pharmaceutical interventions can lead to negative mental health consequences. This study aimed to investigate online self-compassion exercises' effectiveness in alleviating people's negative affect (anxiety and negative emotions) during the COVID-19 pandemic lockdown.

Methods

Study 1 examined the associations between self-compassion and negative affect using an anonymous online survey. In study 2, two pilot experiments were conducted to examine online self-compassion exercises' (i.e., instructor-guided meditation and self-guided writing) effectiveness to mitigate individuals' negative affect. In study 3, a randomized controlled study was conducted to further examine online self-compassion writing's effectiveness in reducing people's negative affect.

Results

The results of study 1 indicated a significant negative association between self-compassion and participants' negative affect. Participants in study 2a reported significant decreases in negative affect after completing the self-compassion meditation. Study 2b showed that participants who completed the self-compassion writing reported significantly more self-compassion and less anxiety when compared to participants who did not. Study 3 showed substantial pre/post-test changes in participants who completed self-compassion writing. Importantly, there were significant increases in participants' self-compassion and decreases in negative affect when compared to participants in the control condition.

Conclusions

Self-compassion exercises were effective to alleviate individuals' anxiety and reduce negative emotions (even within a brief session) during the pandemic lockdown.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12671-021-01674-w.

Randomised Controlled Trial of an Online Version of Compassion Mind Training in a Nonclinical Sample

Compassion Mind Training (CMT) is a therapeutic approach to guide highly self-critical individuals to generate compassion. The goal was to probe the efficacy of a short-term, online version of the CMT on self-compassion and self-criticism in a non-clinical population. We conducted a randomized controlled trial with pre-, post-measurements and two-month follow-up. Out of 144 randomly allocated participants 26 and 20 of those allocated to the intervention and control groups, respectively, completed the follow-up measures. The intervention group was instructed through email to practice a different CMT exercise every day for 13 consecutive days. There was a significant effect of the intervention on self-criticism, especially Hated-self and the Self-uncompassionate responding. The CMT group reported a reduction in negative thoughts and feelings with effects present at the two-month follow-up. There was no significant effect of the intervention on self-reassurance and self-compassion. Self-criticism is amenable to change following a short-term online intervention of CMT delivered to a non-clinical population with effects lasting at least two months. These findings are promising and suggest that interventions designed to reduce self-criticism can be provided to broader populations without direct involvement of mental health professionals.