1. Sign our petition calling on Cochrane to withdraw their review of Exercise Therapy for 'CFS'.
    Dismiss Notice
  2. Guest, the 'News in Brief' for the week beginning 15th July 2024 is here.
    Dismiss Notice
  3. Welcome! Read the Core Purpose and Values of our forum.
    Dismiss Notice

Trial Report Web-Based Self-Compassion Training to Improve the Well-Being of Youth With Chronic Medical Conditions: Randomized Controlled Trial, 2023, Finlay-Jones

Discussion in 'Other health news and research' started by Dolphin, Sep 17, 2023.

  1. Dolphin

    Dolphin Senior Member (Voting Rights)

    Messages:
    5,366
    Free:
    https://www.jmir.org/2023/1/e44016/

    Finlay-Jones AL, Parkinson A, Sirois F, Perry Y, Boyes M, Rees CS
    Web-Based Self-Compassion Training to Improve the Well-Being of Youth With Chronic Medical Conditions: Randomized Controlled Trial
    J Med Internet Res 2023;25:e44016
    doi: 10.2196/44016PMID: 37703081

    Abstract
    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

    [..]

    "Participants were recruited on the internet through open-access websites of community organizations that represent various chronic conditions including epilepsy, diabetes, asthma, cystic fibrosis, and myalgic encephalomyelitis or chronic fatigue syndrome."
     
    Dolphin, Sep 17, 2023
    #1
    Hutan, RedFox and Sean like this.
  2. RedFox

    RedFox Senior Member (Voting Rights)

    Messages:
    1,268
    Location:
    Pennsylvania
    Could be useful if effective but would be very difficult to prove any effect.
     
    RedFox, Sep 17, 2023
    #2
    Ash, Hutan and Sean like this.
  3. Hutan

    Hutan Moderator Staff Member

    Messages:
    27,990
    Location:
    Aotearoa New Zealand
    Yes, the idea of this isn't terrible. But even the gender ratio of participants points to a problem - 87.4% female. While females may perhaps be more likely to have a chronic health condition, I think that ratio suggests that males are a lot less likely to sign up for 'self-compassion training'.

    And then the drop out rate was horrendous.
    Only 29% of people who volunteered for this program (that is, who saw it on the internet and thought it would be a good thing to do) completed it. Clearly, most young people with chronic conditions did not find either the idea or the reality of the programme useful.

    Given all of that, and the small reported benefits in an open label trial with subjective outcomes and a waitlist control, it is not reasonable to conclude
    While the rest of the conclusion is probably mostly right
    I think 'refining the program content' is not what is needed here. The approach needs a fundamental rethink. They probably need to think about the power of being in a supportive group all experiencing similar things; surely group-based approaches, even if just online, are likely to be more useful than individually going through a web-based training program? I think approaches that build communities are likely to be more attractive and useful. Some individuals might do well if given opportunities to help others, in advocacy, for example in annual camps. Some might build useful relationships with others with chronic conditions by being part of an online gaming league...? I don't know. But, I think this study shows that "a 4-week, self-guided, web-based self-compassion training program" or anything that looks very much like that won't be the answer for meeting the need the researchers have identified.

    Personally, I'd like to instead see more research into how to train GPs to work more compassionately with young people with these chronic conditions. I know that some are fine, but I have seen GPs diminishing the self-compassion of young people with chronic conditions. Many of the BPS programmes are highly effective in replacing self-compassion with self-blame.
     
    Last edited: Sep 17, 2023
    Hutan, Sep 17, 2023
    #3
    Sean, alktipping, Lou B Lou and 5 others like this.
  4. Ash

    Ash Senior Member (Voting Rights)

    Messages:
    1,236
    Location:
    UK
    Excellent full analysis. Yes to community relationships.
    I especially appreciated your final thought though.
     
    Ash, Sep 17, 2023
    #4
    Sean, alktipping, Trish and 2 others like this.

Share This Page