Working on self-compassion online: A proof of concept and feasibility study

A qualitative exploration of an autism-specific self-compassion program: The ASPAA

LAY ABSTRACT

Autistic people often struggle to find the right support for their mental health. We wanted to change that by trying a new approach to help autistic adults with their emotions and well-being. We focused on something called "self-compassion," which is a way of being kind and understanding toward ourselves. This approach has worked well for many people, but we didn't know if it would work for autistic individuals. We invited 39 autistic adults to join an online program that taught them about self-compassion. The program lasted 5 weeks and included educational materials, meditation exercises, and self-reflection activities. We asked the participants for feedback each week and at the end of the program. From their responses, we discovered four important things. First, self-compassion had a big positive impact on the well-being of autistic adults. Second, they faced some challenges during the program. Third, they saw self-compassion as a journey that takes time and practice. Finally, they described how they valued changes to help autistic people engage with the program. Our findings show that self-compassion can really help autistic adults. We learned about the benefits they experienced and the difficulties they faced. Most importantly, we found that personalized support is crucial for autistic individuals. By creating programs that consider their specific needs, we can improve their mental health and make their lives better.

Online Video-Mediated Compassion Training Program for Mental Health and Well-Being of University Students

College students experiencing psychological distress have significantly greater negative emotions than students who practice compassionate thinking. We have developed Eight Steps to Great Compassion (ESGC), an innovative brief and no-cost online video training program about how to increase compassion among busy and young adult university students. To examine the effectiveness and benefits of the ESGC, a single-group pre-test-post-test quantitative design with undergraduate university students (N = 92; Mage = 20.39) evaluated its effects. The results from the post-test showed that the ESGC had a significant positive impact on increased feelings of compassion towards oneself, compassion for others, and the sense of personal well-being from the pre-test. The analysis of the PERMA-Profiler subscales also reflected a statistically significant increase in overall well-being and health and a decrease in negative emotions and loneliness. From the Post-Survey Lesson Feedback, 88% of the participants reported significant positive changes in themselves and the way that they live due to the program. These findings appear to show important implications for improving healthy minds and reducing negative emotions among university students.

Online compassion-based self-help for depression in people with skin conditions: a feasibility study

BACKGROUND

There is a need to develop psychological interventions for depression in people with skin conditions. This study aimed to investigate the acceptability, feasibility, and effects of an online compassion-based self-help intervention for depression in people with skin conditions.

METHODS

Adult participants (n = 34) with skin conditions and mild-moderate depressive symptoms were invited to undertake a six-week, compassion-based online intervention for depression with email support. Engagement with the intervention was monitored, along with time spent facilitating the intervention, and participant feedback was collected each week and post-intervention. Pre-post changes in depression, self-compassion and dermatological quality of life were also assessed.

RESULTS

The intervention was started by 25 participants and completed by 13. Feedback scores indicated that the website was evaluated positively and that the sessions had positive impacts on participants. Participants appreciated the skin-specific aspects of the intervention but varied as to which of the compassion-based exercises they found helpful. The online intervention was feasible to provide and facilitate, and treatment completers showed improvements in depression, quality of life and self-compassion.

CONCLUSIONS

The online compassion-based intervention holds promise as a treatment for depression in people with skin conditions. Recommendations are made for future research and further development of the intervention.

TRIAL REGISTRATION

This study was registered at ClinicalTrials.gov on 21 October 2019, NCT04132973.

Effectiveness of compassion-based online therapy on suicidal thoughts and pain catastrophizing in female patients with multiple sclerosis in the relapsing-remitting phase

Introduction

According to research, multiple sclerosis is related to suicidal thoughts and pain catastrophizing as psycho-pathological variables, and on the other hand, compassion-based treatment can reduce mental disorders by targeting dimensions such as self-compassion. Also, since this disease is progressive and over time can cause movement restrictions in these people, online psychotherapy can be a better option for these people. So, the purpose of this study was to investigate the effectiveness of online compassion therapy on suicidal thoughts and pain catastrophizing in female patients with multiple sclerosis.

Methods

The current research was applied and quasi-experimental in a pre-test-post-test manner with a control group. The research sample consisted of 30 patients with multiple sclerosis living in Shiraz in 2019, who were randomly divided into two 15-person experimental and control groups. The participants were tested on scales of suicidal thoughts and pain catastrophizing, and the treatment plan based on compassion therapy was presented to the participants of the experimental group in 8 two-hour sessions online. The control group was placed on the waiting list until the completion of the treatment sessions and the post-test implementation, and after the post-test implementation, they received the treatment. Control variables in this study included gender and disease phase. Then, their scores were measured, after completing the treatment, and a three-month follow-up period. Descriptive statistics and covariance test were used to analyze the data.

Results

Patients showed a clear improvement in the severity of symptoms in both variables. So that the scores of suicidal thoughts and pain catastrophizing in the experimental group after receiving the treatment, as well as after a three-month follow-up period, were significantly reduced (p < 0.001).

Conclusion

Confirming the effectiveness of online therapy based on compassion on improving psychological outcomes in these patients, as an effective and online treatment method, is a clear step towards continuing the implementation of psychological interventions and paying attention to the dimension of mental health in this group of people.

Web-Based Self-Compassion Training to Improve the Well-Being of Youth With Chronic Medical Conditions: Randomized Controlled Trial

BACKGROUND

Up to one-third of young people live with chronic physical conditions (eg, diabetes, asthma, and autoimmune disease) that frequently involve recurrent pain, fatigue, activity limitations, stigma, and isolation. These issues may be exacerbated as young people transition through adolescence. Accordingly, young people with chronic illness are at a high risk of psychological distress. Accessible, evidence-based interventions for young people with chronic illnesses are urgently needed to improve well-being, support adaptation, and enhance daily functioning. Self-compassion, which is an adaptive means of relating to oneself during times of difficulty, is a promising intervention target for this population.

OBJECTIVE

This study aims to test the efficacy of a 4-week, self-guided, web-based self-compassion training program for improving well-being among young Australians (aged 16-25 years) living with a chronic medical condition. The primary outcomes were self-compassion, emotion regulation difficulties, and coping; the secondary outcomes were well-being, distress, and quality of life. We also sought to test whether changes in primary outcomes mediated changes in secondary outcomes and gather feedback about the strengths and limitations of the program.

METHODS

We conducted a single-blind, parallel-group, randomized controlled trial comparing a 4-week, fully automated, web-based self-compassion training program with a waitlist control. Participants were recruited via the internet, and outcomes were self-assessed at 4 (T1) and 12 weeks (T2) after the baseline time point via a web-based survey. A mixed methods approach was used to evaluate the program feedback.

RESULTS

Overall, 151 patients (age: mean 21.15, SD 2.77 years; female patients: n=132, 87.4%) were randomized to the intervention (n=76, 50.3%) and control (n=75, 49.7%) groups. The loss-to-follow-up rate was 47.4%, and program use statistics indicated that only 29% (22/76) of young people in the experimental group completed 100% of the program. The main reported barrier to completion was a lack of time. As anticipated, treatment effects were observed for self-compassion (P=.01; partial η2=0.05; small effect); well-being (P≤.001; partial η2=0.07; medium effect); and distress (P=.003; partial η2=0.054; small-medium effect) at the posttest time point and maintained at follow-up. Contrary to our hypotheses, no intervention effects were observed for emotion regulation difficulties or maladaptive coping strategies. Improvements in adaptive coping were observed at the posttest time point but were not maintained at follow-up. Self-compassion, but not emotion regulation difficulties or coping, mediated the improvements in well-being.

CONCLUSIONS

Minimal-contact, web-based self-compassion training can confer mental health benefits on young people with chronic conditions. This group experiences substantial challenges to participation in mental health supports, and program engagement and retention in this trial were suboptimal. Future work should focus on refining the program content, engagement, and delivery to optimize engagement and treatment outcomes for the target group.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry 12619000572167; https://tinyurl.com/5n6hevt.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1186/s12889-020-8226-7.

A pilot study of an online self-compassion intervention for adults who stutter

PURPOSE

The primary aim of this pilot study was to determine the preliminary effectiveness of an online self-compassion intervention for improving self-compassion and quality of life in adults who stutter. A secondary aim was to determine intervention acceptability and participant satisfaction.

METHOD

Participants included adults who stutter who completed an online self-compassion module once a week for six consecutive weeks. Pre- and post-intervention measures included the Self-Compassion Scale-Trait and the Overall Assessment of the Speaker's Experience of Stuttering. Participants also completed acceptability questionnaires weekly and post-intervention via quantitative and qualitative reports.

RESULT

Ten participants completed all six intervention modules, as well as pre- and post-intervention measures. Participants reported increased self-compassion and improved quality of life at post-intervention, as well as high intervention acceptability with regard to delivery format, content, duration, and relevance to stuttering and daily life. Individual variation was also observed across acceptability domains.

CONCLUSION

The present study provides pilot data supporting the use of online modules to increase self-compassion and decrease the negative impact of stuttering on the quality of life among adults who stutter. Future studies should employ larger sample sizes, compare outcomes to a control group, and determine if gains are maintained over time.

Experiences of Users with an Online Self-Guided Mental Health Training Program Using Gamification

Young adulthood is a period of high risk for the development of mental health concerns. Increasing well-being among young adults is important to prevent mental health concerns and their consequences. Self-compassion has been identified as a modifiable trait with the potential to protect against mental health concerns. An online self-guided mental health training program using gamification was developed and the user experience was evaluated in a 6-week experimental design. During this period, 294 participants were allocated to use the online training program via a website. User experience was assessed via self-report questionnaires, and interaction data for the training program were also collected. Results showed that those who completed the intervention (n= 47) visited the website on average 3.2 days a week, with a mean of 45.8 interactions during the 6 weeks. Participants report positive user experiences of the online training, on average a System Usability Scale Brooke (1) score of 79.1 (out of 100) at the end-point. Participants showed positive engagement with story elements of the training, based on an average score of 4.1 (out of 5) in the evaluation of the story at the end-point. This study found the online self-compassion intervention for youth to be acceptable, although some features seem preferred by users as compared to others. Gamification in the form of a guiding story and a reward structure seemed to be a promising element for successfully motivating participants and serving as a guiding metaphor for self-compassion.

The impact of Emotion-focused training for emotion couching delivered as mobile app on self-compassion and self-criticism

Introduction

Being self-compassionate is considered a beneficial emotion regulation strategy. Therefore, the acquisition of emotional skills can raise self-compassion levels and consequently reduce self-criticism.

Methods

Hence, the goal of the current study was to develop a mobile app based on the empirically proven group version of Emotion-Focused Training for Emotional Coaching (EFT-EC) and test its effectiveness in reducing self-criticism and raising self-compassion and self-protection. The sample consisted of 85 participants, of whom 22.4% were men and 77.6% were women. The mean age was 32.53 (SD = 14.51), ranging from 18 to 74 years. The participants filled out the following scales immediately before and after using the fourteen-day mobile app: The Forms of Self-Criticizing/Attacking & Self-Reassuring Scale (FSCRS), The Sussex-Oxford Compassion for the Self Scale (SOCS-S), and The Short-form Version of The Scale for interpersonal behaviour (s-SIB).

Results

Use of the 14-day EFT-EC mobile app significantly improved self-compassion and self-reassurance and significantly reduced self-criticism compared to pre- and post-measurements.

Discussion

The results are promising as self-criticism is a transdiagnostic phenomenon observed in various kinds of psychopathology and reducing it may prevent the emergence of psychopathologies. Moreover, the mobile app intervention can easily be accessed by a wide range of users, without requiring the services of a mental health professional, and thereby reduces the potential risk of shame or stigmatization.

Compas-Y: A mixed methods pilot evaluation of a mobile self-compassion training for people with newly diagnosed cancer

Objective

Compas-Y is a compassionate mind training app that was co-designed to be fully adapted to mobile technology and to people with newly diagnosed cancer. This study aimed to evaluate the use, appreciation and impact of the app.

Methods

Seventy-one people with cancer who created an app account were included (38% breast cancer, 72% diagnosed <4 months ago, 76% received chemotherapy). Participants had very high baseline scores of self-compassion. In a convergent mixed methods design, back-end log-data (n = 71), pre-post surveys (n = 34) and semi-structured interviews (n = 23) collected for >8 weeks and were concurrently analysed using joint displays.

Results

About half of the participants (45%) used 4 of the 6 modules. Compas-Y was highly appreciated, with all content considered relevant and a source of support. Experienced benefits related to improved mental health. Particularly, we found significant changes in anxiety, but not in depression or well-being. In the interviews, people reported experiencing more rest and more positive emotions due to using the app. Process benefits included significant reductions in self-criticism (inadequate self and self-blame), but not self-compassion. In the interviews, people reported improved self-compassion and less self-criticism, more self-awareness, recognition and support, and improved emotion regulation and coping. The surveys did not capture the full range of outcomes that participants reported in the interviews.

Conclusions

Compas-Y is a highly appreciated mobile intervention that supported users in aspects of their mental health. Findings are discussed in terms of reach and adherence, app functionalities, co-design and tailoring of cancer-related and compassion-based eHealth.

Development of a novel COMPAssion focused online psyChoTherapy for bereaved informal caregivers: the COMPACT feasibility trial protocol

INTRODUCTION

An easy-to-access and effective psychotherapy for bereaved informal caregivers has not been established. People with higher self-compassion status tend to have lower bereavement related grief, psychotherapy focused on self-compassion can be promising for this population. This study aimed to examine the feasibility of online self-compassion focused psychotherapy for bereaved informal caregivers.

METHOD AND ANALYSIS

A total of 60 study participants will undergo an intervention programme comprising online sessions of 2 hours per week for five consecutive weeks and undertake postsession work. The intervention personnel will comprise psychologists who have received more than 10 hours of structured training. The primary endpoint will be assessed on the intervention completion rate, with secondary endpoints consisting of the Complicated Grief Questionnaire, Patient Health Questionnaire-9, Generalised Anxiety Disorder-7, Brief Resilience Scale and Self-Compassion Scale. Evaluations will be conducted preintervention, immediately after intervention, and 4 and 12 weeks after intervention.

ETHICS AND DISSEMINATION

This study has been reviewed and approved by the Ethics Committee of the Kyoto University Graduate School and Faculty of Medicine, Kyoto University Hospital, Japan (Approved ID: C1565). The results of this study will be disseminated through publication in a peer-reviewed journal and conference presentations.

TRIAL REGISTRATION NUMBER

UMIN000048554.

Self-compassion Intervention for Parents of Children with Developmental Disabilities: A Feasibility Study

Objectives

Parents of children with developmental disabilities (DDs) experience greater psychological distress (e.g., stress and depression) compared to parents of children without DDs. Self-compassion (i.e., responding with compassion to oneself during times of stress and difficulty) is associated with greater self-care as well as lower levels of stress, depression, and internalized stigma among parents of children with DDs. In this study, we tested the feasibility of a 4-week brief, asynchronous, online intervention targeting self-compassion among parents of children with DDs.

Methods

Participants were fifty parents (48 mothers; 2 fathers) of children with DDs. Participants' ages ranged from 25 to 62 years (M = 42.1 years, SD = 7.9 years), and 88% of participants had one child with a DD, and the remaining parents had two or more children with DDs. Child diagnoses included Down syndrome, autism spectrum disorder, and intellectual disability. Feasibility was assessed in five domains (i.e., acceptability, demand, implementation, practicability, and limited efficacy) using a combination of self-report measures, qualitative feedback, and data on attrition.

Results

Most parents (84%) completed ≥ 3 modules, and 74% completed all four modules. Almost all parents (> 90%) reported that they would recommend the intervention to others. Paired-samples t-tests demonstrated significant pre-intervention to post-intervention increases in self-compassion and well-being, and significant reductions in parent depression and stress.

Conclusions

Overall, data support feasibility of the 4-week intervention targeting parent self-compassion and provide preliminary efficacy data that need to be followed up in a larger randomized control trial.

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.

The Role of Self-Compassion Among Adaptive and Maladaptive Perfectionists in University Students

Using the tripartite model of perfectionism that accounts for combined characteristics of the Perfectionistic Strivings and Perfectionistic Concerns dimensions, this study explored the mediating role of self-compassion to explain differences between adaptive and maladaptive perfectionists in four psychological distress domains: depression, generalized anxiety, social anxiety, and academic distress. A sample of 3,112 university students were classified into adaptive, maladaptive, and nonperfectionists. Results of mediation analyses comparing adaptive and maladaptive perfectionists indicated that adaptive perfectionists reported significantly greater self-compassion and lower psychological distress levels in all four areas. Self-compassion significantly mediated the associations between perfectionist groups in all four domains. These findings were largely supported across various ethnic and international student groups in the analyses by subgroups. Furthermore, parallel mediation analyses demonstrated the unique contributions of individual self-compassion subscales as mediators. Implications for clinical practice, training, and future research are discussed.

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.

The effects of loving-kindness and compassion meditation on life satisfaction: A systematic review and meta-analysis

Loving-kindness and compassion meditation (LKCM) was a promising intervention for improving life satisfaction, but previous findings have been inconsistent. The current study provides a systematic review and meta-analysis, including 23 empirical studies on LKCM with life satisfaction as an outcome variable. The primary meta-analysis indicated that LKCM significantly enhanced life satisfaction in pre-post design (g = 0.312, k = 15, n = 451), but the significance disappeared in the additional meta-analysis based on randomized controlled trials (g = 0.106, k = 6, n = 404). Moderator analyses found significant effects for type of control (i.e., the effects of LKCM were inferior to active control group, but superior to waitlist condition), but not for other moderators (i.e., participant type, previous meditation experience, specific protocol, components of LKCM, combination with mindfulness mediation, and intervention length). Narrative review identified self-compassion and positive emotions as important mediators. The practice time of LKCM had indirect but not direct association with life satisfaction. The findings supported that LKCM is promising in increasing life satisfaction, but more studies are needed to investigate the effects with more rigorous designs. Future studies should investigate other potential mechanisms and clarify whether LKCM change the reality or the perception of life.

An App-Based Mindfulness-Based Self-compassion Program to Support Caregivers of People With Dementia: Participatory Feasibility Study

BACKGROUND

The number of persons with dementia is steadily growing, as is the number of individuals supporting persons with dementia. Primary caregivers of persons with dementia are most often family members or spouses of the persons with dementia, and they are more likely to experience increased stress and other negative effects than individuals who are not primary caregivers. Although in-person support groups have been shown to help buffer the negative impacts of caregiving, some caregivers live in isolated or rural communities and are unable to make the burdensome commitment of traveling to cities. Using an interdisciplinary approach, we developed a mobile smartphone support app designed for primary caregivers of persons with dementia, with the goal of reducing caregiver burden and easing stress. The app features a 12-week intervention, largely rooted in mindfulness-based self-compassion (MBSC), because MBSC has been linked to minimizing stress, depression, and anxiety.

OBJECTIVE

The primary objectives of our program are twofold: to explore the feasibility of a 12-week mobile support program and to conduct an initial efficacy evaluation of changes in perceived caregiver burden, coping styles, and emotional well-being of caregivers before and after the program.

METHODS

Our feasibility study used a 2-phase participatory pretest and posttest design, focusing on acceptability, demand, practicality, implementation, and efficacy. At phase I, we recruited 57 primary caregivers of persons with dementia (mean age 76.3, SD 12.9 years), comprising spouses (21/57, 37%), children (21/57, 37%), and friends or relatives (15/57, 26%) of persons with dementia, of whom 29 (51%) completed all measures at both pre- and postprogram. The content of the program featured a series of MBSC podcasts. Our primary outcome measure was caregiver burden, with secondary outcome measures including coping styles and emotional well-being. Daily ecological momentary assessments enabled us to ask participants, "How are you feeling today?" Phase II of our study involved semistructured follow-up interviews with most participants (n=21) who completed phase I.

RESULTS

Our findings suggest that our app or program meets the feasibility criteria examined. Notably, participants generally accepted the program and believed it could be a useful resource. Emotional well-being increased significantly (P=.04), and emotion-based coping significantly decreased (P=.01). Participants generally considered the app or program to be a helpful resource.

CONCLUSIONS

Although there were no significant changes in caregiver burden, we were encouraged by the increased emotional well-being of our participants following the completion of our program. We also conclude that our app or program demonstrated feasibility (ie, acceptability, practicality, implementation, and efficacy) and can provide a much-needed resource for primary caregivers of persons with dementia. In the subsequent version of the program, we will respond to participant feedback by incorporating web-based weekly sessions and incorporating an outcome measure of self-compassion.

A Multilevel Multidimensional Finite Mixture Item Response Model to Cluster Respondents and Countries

Abstract. The aim of this study was to test the multilevel multidimensional finite mixture item response model of the Forms of Self-Criticising/Attacking and Self-Reassuring Scale (FSCRS) to cluster respondents and countries from 13 samples ( N = 7,714) and from 12 countries. The practical goal was to learn how many discrete classes there are on the level of individuals (i.e., how many cut-offs are to be used) and countries (i.e., the magnitude of similarities and dissimilarities among them). We employed the multilevel multidimensional finite mixture approach which is based on an extended class of multidimensional latent class Item Response Theory (IRT) models. Individuals and countries are partitioned into discrete latent classes with different levels of self-criticism and self-reassurance, taking into account at the same time the multidimensional structure of the construct. This approach was applied to the analysis of the relationships between observed characteristics and latent trait at different levels (individuals and countries), and across different dimensions using the three-dimensional measure of the FSCRS. Results showed that respondents’ scores were dependent on unobserved (latent class) individual and country membership, the multidimensional structure of the instrument, and justified the use of a multilevel multidimensional finite mixture item response model in the comparative psychological assessment of individuals and countries. Latent class analysis of the FSCRS showed that individual participants and countries could be divided into discrete classes. Along with the previous findings that the FSCRS is psychometrically robust we can recommend using the FSCRS for measuring self-criticism.

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.

Efficacy of Guided Versus Self-Induced Learning of Web-Based Self-Compassionate Journaling by College Students

We conducted 3 studies examining the efficacy of web-based self-compassionate journaling (SCJ). The goal was to compare the effects of guided and self-administered journaling on self-reported follow-up self-compassion scores and participant perceptions of the induction. In Study 1 participants were randomly assigned to an online SCJ exercise, online narrative journaling control group, or attention control (AC) group, with groups completing tasks for 4 weeks. In Study 2 participants self-selected into either online or in-lab conditions to complete a single-time SCJ exercise. Study 3 was a replication of Study 2, with participants being randomly assigned to conditions. There were no differences in self-compassion between groups in Study 1. However, there was a small but significant overall increase in self-compassion among participants from baseline to follow-up. There were self-compassion differences between online and in-lab groups in Study 2 (with a small effect size). However, these differences were not maintained when the covariate of baseline trait self-compassion was removed from analyses. Study 3 failed to replicate significant findings from Study 2 in all but one variable: whether participants completing the induction alone found the task more difficult to complete. In general, SCJ may not be an adequate way to increase self-compassion regardless of whether it is learned online or in a laboratory setting. Furthermore, those who learn SCJ alone online report difficulty in completing the induction.

The effectiveness of smartphone compassion training on stress among Swedish university students: A pilot randomized trial

OBJECTIVE

To investigate the effects of a 6-week smartphone compassion training intervention on mental health.

METHOD

Fifty-seven Swedish university students (mean age = 25, SD = 5) reporting high levels of stress were randomized to compassion training (n = 23), mindfulness (n = 19), or waitlist (n = 15).

RESULT

Multilevel models indicated that both compassion and mindfulness training increased self-compassion compared to the waitlist, while only compassion significantly reduced stress. Between-group effect sizes for compassion compared to waitlist were large for both self-compassion (d = 1.61) and stress (d = 0.94). Compassion and mindfulness did not differ significantly, but effect sizes were in favor of compassion. Secondary outcomes indicated positive effects on emotional awareness, while no effect was found for global psychological distress.

CONCLUSIONS

Our results suggest that compassion training via a smartphone application can improve self-compassion and reduce stress among university students. Future studies in larger clinical samples are warranted.

Self-compassion in undergraduate nursing: an integrative review

Objective To explore self-compassion and its role in supporting well-being, compassionate care, and the academic experience in undergraduate nursing students. Method Whittemore and Knafl's (2005) integrative review methodology was used to search articles published between 2007 and 2020, which resulted in 36 articles meeting the inclusion criteria: compassion for self and others, strategies to support self-compassion; and self-compassion and student learning. Result Findings indicate that self-compassion may promote compassionate care, personal well-being, resilience, and emotional intelligence while supporting indicators of academic success. Compassion literacy, mindfulness training, and experiential exercises are some of the strategies that could be integrated into nursing curricula to enhance compassion in nursing students for self and others. Conclusion Integrating mindfulness and self-compassion in undergraduate curricula requires innovative teaching and learning approaches within a supportive organizational environment. To this end, a Self-Compassion Curricular Model to guide nursing programs is proposed.

Feasibility of the Internet Attachment-Based Compassion Therapy in the General Population: Protocol for an Open-Label Uncontrolled Pilot Trial

Background

Compassion-based interventions delivered over the internet are showing promising results for the promotion of psychological health and well-being. Several studies have highlighted their feasibility, acceptance, and preliminary efficacy. However, this is an incipient field of research, and to the best of our knowledge, there are no data available from Spanish-speaking countries.

Objective

The aim of this study is to investigate the feasibility, acceptance, and preliminary efficacy of the Internet Attachment–Based Compassion Therapy (iABCT), a web-based version of the Attachment-Based Compassion Therapy, in Spanish speakers from the general population.

Methods

This feasibility study features a single-arm, uncontrolled, within-group design with an embedded qualitative and quantitative process evaluation at baseline, immediately after the intervention and at the 3-month follow-up. A minimum of 35 participants from the general population will be allocated to iABCT. Feasibility measures will include attrition rate, patterns of use of the web-based system, and participants’ acceptability, usability, and opinion. The primary outcome was measured using the Pemberton Happiness Index. Secondary outcomes were measured using the Compassion Scale, Self-Compassion Scale, Forms of Self-Criticizing/Attacking and Self-Reassuring Scale-Short form, Five Facets of Mindfulness Questionnaire, Relationships Questionnaire, General Health Questionnaire, Non-Attachment Scale, International Positive and Negative Affect Schedule Short Form, Purpose-In-Life Test, and difficulties regarding the practice of compassion (Compassion Practice Quality Questionnaire). Mixed models will be used to evaluate primary and secondary outcome measures. A qualitative content analysis of the participants’ qualitative responses will also be performed.

Results

Enrollment started in February 2020 and will be finished in April 2020. Data analysis will start in October 2020.

Conclusions

To our knowledge, this study will, for the first time, show data on the feasibility, acceptability, and preliminary efficacy of web-based compassion (and self-compassion) training—that is, the adapted iABCT—in Spanish speakers from the general population. Further aspects of their implementation (ie, facilitators, barriers, and unwanted effects) and mechanisms of change will be investigated. This study will allow the revision and fine-tuning of the developed intervention, study design, and planning procedures, as well as the initiation of a future randomized controlled trial.

Trial Registration

Clinicaltrials.gov: NCT03918746. Registered on April 17, 2019. Protocol version 1, 6 March 2019.

International Registered Report Identifier (IRRID)

PRR1-10.2196/16717

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.

Validation of the French version of the Forms of Self-Criticizing/Attacking and Self-Reassuring Scale

BACKGROUND

Self-criticism and self-reassurance are internal processes of self-to-self relating that have received increasing attention in psychology. The Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS), which was first studied by Gilbert, Clarke, Hempel, Miles, and Irons, is a self-report instrument that has been used in various populations and has shown satisfactory reliability. The goal of this work is to explore the psychometric properties of a French version of the scale in a large nonclinical sample.

METHOD

Data from 285 nonclinical participants were analysed.

RESULTS

Confirmatory factor analysis indicated an acceptable to good fit of the FSCRS items to a three-factor model. Good internal consistency and convergent validity were found.

CONCLUSIONS

The French validation results corroborate previous findings in a nonclinical population and confirm that the French version of the FSCRS is a robust and reliable instrument.

An Internet-Based Compassion-Focused Intervention for Increased Self-Criticism: A Randomized Controlled Trial

Increased levels of self-criticism and a lack of self-compassion have been associated with the development and maintenance of a range of psychological disorders. In the current study, we tested the efficacy of an online version of a compassion-focused intervention, mindfulness-based compassionate living (MBCL), with guidance on request. A total of 122 self-referred participants with increased levels of self-criticism were randomly assigned to care as usual (CAU) or the intervention group (CAU + online intervention). Primary endpoints were self-reported depressive, anxiety and distress symptoms (DASS-21) and self-compassion (SCS) at 8 weeks. Secondary endpoints were self-criticism, mindfulness, satisfaction with life, fear of self-compassion, self-esteem, and existential shame. At posttreatment, the intervention group showed significant changes with medium to large effect sizes compared to the control group regarding primary outcomes (Cohen's d: 0.79 [DASS] and -1.21 [SCS]) and secondary outcomes (Cohen's ds: between 0.40 and 0.94 in favor of the intervention group). The effects in the intervention group were maintained at 6-months postrandomization. Adherence measures (number of completed modules, self-reported number of completed exercises per week) predicted postintervention scores for self-compassion but not for depressive, anxiety, and distress symptoms in the intervention group. The current study shows the efficacy of an online intervention with a transdiagnostic intervention target on a broad range of measures, including depressive and anxiety symptoms and self-compassion.

Mindful Self-Compassion Training Reduces Stress and Burnout Symptoms Among Practicing Psychologists: A Randomized Controlled Trial of a Brief Web-Based Intervention

Objective: The aims of this study were (a) to examine the effects of a 6 weeks web-based mindful self-compassion program on stress and burnout symptoms in a group of practicing psychologists, and (b) to examine relationships between changes in self-compassion and self-coldness and changes in stress and burnout symptoms.

Method: In a randomized controlled trial, 101 practicing psychologists were assigned to a training group (n = 51) or a wait-list control group (n = 49). The training encompassed 15 min exercises per day, 6 days a week, for 6 weeks. The participants completed the Self-Compassion Scale (SCS), the Five Facets of Mindfulness Questionnaire (FFMQ), the Perceived Stress Scale (PSS), and the Shirom Melamed Burnout Questionnaire (SMBQ) pre and post intervention.

Results: Eighty-one participants (n = 40 in the training group, n = 41 in the control group) took part in the pre and post intervention assessments. Selective gains for the intervention group were observed for SCS total scores (d = 0.86; d = 0.94 for the SCS), FFMQ scores (d = 0.60), while levels of self-coldness was reduced (d = 0.73). Critically, levels of perceived stress (d = 0.59) and burnout symptoms (d = 0.44 for SMBQ total) were additionally lowered post intervention. Finally, the results confirmed the hypothesis that the measures of distress would be more strongly related to self-coldness than self-compassion, a pattern seen in cross-sectional analyses and, for burnout, also in the longitudinal analyses.

Conclusions: This training program appeared effective to increase self-compassion/reduce self-coldness, and to alleviate stress and symptoms of burnout and provide support of the distinction between self-compassion and self-coldness. Additional studies, preferably three-armed RCTs with long-term follow-up, are warranted to further evaluate the effectiveness of the program.

The Factor Structure of the Forms of Self-Criticising/Attacking & Self-Reassuring Scale in Thirteen Distinct Populations

There is considerable evidence that self-criticism plays a major role in the vulnerability to and recovery from psychopathology. Methods to measure this process, and its change over time, are therefore important for research in psychopathology and well-being. This study examined the factor structure of a widely used measure, the Forms of Self-Criticising/Attacking & Self-Reassuring Scale in thirteen nonclinical samples (N = 7510) from twelve different countries: Australia (N = 319), Canada (N = 383), Switzerland (N = 230), Israel (N = 476), Italy (N = 389), Japan (N = 264), the Netherlands (N = 360), Portugal (N = 764), Slovakia (N = 1326), Taiwan (N = 417), the United Kingdom 1 (N = 1570), the United Kingdom 2 (N = 883), and USA (N = 331). This study used more advanced analyses than prior reports: a bifactor item-response theory model, a two-tier item-response theory model, and a non-parametric item-response theory (Mokken) scale analysis. Although the original three-factor solution for the FSCRS (distinguishing between Inadequate-Self, Hated-Self, and Reassured-Self) had an acceptable fit, two-tier models, with two general factors (Self-criticism and Self-reassurance) demonstrated the best fit across all samples. This study provides preliminary evidence suggesting that this two-factor structure can be used in a range of nonclinical contexts across countries and cultures. Inadequate-Self and Hated-Self might not by distinct factors in nonclinical samples. Future work may benefit from distinguishing between self-correction versus shame-based self-criticism.