A Self-Compassion and Mindfulness-Based Cognitive Mobile Intervention (Serene) for Depression, Anxiety, and Stress: Promoting Adaptive Emotional Regulation and Wisdom

Abstract

Introduction: Many individuals and families are currently experiencing a high level of COVID-19-related stress and are struggling to find helpful coping mechanisms. Mindfulness-based interventions are becoming an increasingly popular treatment for individuals experiencing depression and chronic levels of stress. The app (Serene) draws from scholarly evidence on the efficacy of mindfulness meditations and builds on the pre-existing apps by incorporating techniques that are used in some therapies such as cognitive behavioral therapy and mindfulness-based cognitive therapy.Methods: Participants were randomly assigned to a 4-week mindfulness and self-compassion-based cognitive smartphone intervention (Serene) or a wait-list control group. They were instructed to engage in self-compassion and mindfulness practices and a cognitive restructuring task. They also completed measures that evaluated their levels of depression, stress, anxiety, self-compassion, wisdom, psychological well-being, and subjective well-being. The intervention group was also instructed to track their weekly engagement with the app. Standardized effect sizes for between-group differences were calculated using Cohen's d for complete case analyses.Results: Complete case analyses from baseline to the end of this randomized controlled trial demonstrated significant moderate between-group differences for depressive symptoms (d = −0.43) and decisiveness (d = 0.34). Moderate between-group differences were also found for self-compassion (d = 0.6) such that significant improvements in self-kindness, common humanity, mindfulness and decreases in self-judgement, isolation, and overidentification were observed. A small between-group difference was found for emotional regulation (d = 0.28). Moreover, a significant moderate within-group decrease in stress (d = −0.52) and anxiety symptoms (d = −0.47) was also observed in the intervention group.Conclusions: Serene is an effective intervention that promotes increased levels of self-compassion and emotional regulation. Engaging with Serene may help reduce depressive symptoms through mindfulness, self-compassion, and cognitive restructuring which help reduce overidentification with one's negative emotions. As individuals rebalance their thinking through cognitive restructuring, they can identify the varying stressors in their life, develop action plans and engage in adaptive coping strategies to address them. Serene may promote greater self-understanding which may provide one with a more balanced perspective on their current upsetting situations to positively transform their challenges during the pandemic.

Predict, prevent and manage moral injuries in Canadian frontline healthcare workers and leaders facing the COVID-19 pandemic: Protocol of a mixed methods study

“…Psychosocial interventions have been considered the most effective ways to reduce distress, alleviate psychological symptoms and promote psychological resilience during the ongoing pandemic ( Al-Refae et al, 2021 ; Dawel et al, 2020 ; Galea et al, 2020 ). However, such interventions rarely included actions to reduce PSW.…”

Psychological Interventions in a Pandemic Emergency: A Systematic Review and Meta-Analysis of SARS-CoV-2 Studies

“…Twelve studies of psychological interventions on people during the SARS-CoV-2 pandemic were identified for inclusion [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. All studies were published in 2020 and 2021 and published in indexed journals.…”

“…The sample sizes ranged from 9 participants to 1500 participants. Seven studies included patients, of which three studies included people with a mean age ranging from 40.8 to 48.3 years [ 19 , 24 , 25 ], two studies included people with a mean age ranging from 34.6 to 36.8 years [ 22 , 26 ], and two studies included younger people with a mean age ranging from 26.1 to 28.5 years [ 23 , 28 ]. Another study included health care workers without personal identifying information being collected [ 18 ].…”

“…The type of psychological intervention was predominantly cognitive behavioral therapy (CBT) [ 18 , 19 , 20 , 21 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ], and the total duration of therapy ranged from 10 min to 1 h per day [ 19 , 22 , 25 ] and per week [ 21 , 23 , 24 , 26 , 29 ]. Of them, in two studies, the psychological intervention type was mindfulness-based intervention (MBI) [ 21 , 28 ]; Malboeuf-Hurtubise et al [ 21 ] compared MBI with a psycho-educational approach with a session duration of 1 h per week. Three studies did not clearly specify the number of sessions performed and session duration [ 18 , 20 , 27 ].…”

Abbreviated San Diego Wisdom Scale (SD-WISE-7) and Jeste-Thomas Wisdom Index (JTWI)

“…In previous work, we have shown that scores on the original SD-WISE are reliable, valid, and have positive correlations with measures of good mental health and well-being as well as negative correlations with measures of poor mental health (Jeste et al, 2021). The scale is increasingly being used in large national and international studies (Jeste et al, 2020a(Jeste et al, , 2020bNguyen et al, 2020), biological research (Grennan et al, 2021;Nguyen et al, 2021;Thomas et al, 2019b), and clinical trials (Treichler et al, 2020), including a recent study that demonstrated positive change in specific components of the SD-WISE following a mindfulness intervention (Al-Refae et al, 2021).…”