Exploring putative therapeutic mechanisms of change in a hybrid compassion-focused, ecological momentary intervention: Findings from the EMIcompass trial

TY - JOUR

T1 - Exploring putative therapeutic mechanisms of change in a hybrid compassion-focused, ecological momentary intervention

T2 - Findings from the EMIcompass trial

AU - Paetzold, Isabell

AU - Schick, Anita

AU - Rauschenberg, Christian

AU - Hirjak, Dusan

AU - Banaschewski, Tobias

AU - Meyer-Lindenberg, Andreas

AU - Boehnke, Jan R.

AU - Boecking, Benjamin

AU - Reininghaus, Ulrich

N1 - Funding Information: This work was supported by the German Research Foundation (DFG) [grant number 389626655 ] and DFG Heisenberg professorship [grant number 389624707 ] to UR. Copyright: © 2023 Elsevier Ltd. All rights reserved.

PY - 2023/9

Y1 - 2023/9

N2 - Compassion-focused interventions represent a promising transdiagnostic approach, but the mechanisms involved in hybrid delivery combining face-to-face sessions and an ecological momentary intervention remain unexplored. The current study aimed at exploring associations of putative mechanisms with clinical outcomes at post-intervention/follow-up and mediation of outcome at follow-up by preceding pre-to post-intervention changes in putative mechanisms. The compassion-focused EMIcompass intervention was applied in an exploratory randomized controlled trial (treatment as usual (TAU) vs. TAU + EMIcompass) with youth with early mental health problems. Data was collected before randomization, at post-intervention and at four-week follow-up. We recruited N = 92 participants, N = 46 were allocated to the experimental condition. After control for baseline levels of the target outcomes, baseline-to post-intervention improvement in adaptive emotion regulation was associated with lower levels of clinical outcomes (e.g. psychological distress b = −1.15; 95%CI = −1.92 to −0.39) across time points. We could not detect indirect effects, but we observed associations of change in self-compassion and adaptive emotion regulation with outcomes at follow-up in the mediation analysis (e.g., β = −0.35, 95%CI = −0.52 to −0.16). If successfully targeted by interventions, self-compassion and emotion regulation may be promising putative therapeutic mechanisms of change.

AB - Compassion-focused interventions represent a promising transdiagnostic approach, but the mechanisms involved in hybrid delivery combining face-to-face sessions and an ecological momentary intervention remain unexplored. The current study aimed at exploring associations of putative mechanisms with clinical outcomes at post-intervention/follow-up and mediation of outcome at follow-up by preceding pre-to post-intervention changes in putative mechanisms. The compassion-focused EMIcompass intervention was applied in an exploratory randomized controlled trial (treatment as usual (TAU) vs. TAU + EMIcompass) with youth with early mental health problems. Data was collected before randomization, at post-intervention and at four-week follow-up. We recruited N = 92 participants, N = 46 were allocated to the experimental condition. After control for baseline levels of the target outcomes, baseline-to post-intervention improvement in adaptive emotion regulation was associated with lower levels of clinical outcomes (e.g. psychological distress b = −1.15; 95%CI = −1.92 to −0.39) across time points. We could not detect indirect effects, but we observed associations of change in self-compassion and adaptive emotion regulation with outcomes at follow-up in the mediation analysis (e.g., β = −0.35, 95%CI = −0.52 to −0.16). If successfully targeted by interventions, self-compassion and emotion regulation may be promising putative therapeutic mechanisms of change.

KW - Transdiagnostic intervention

KW - mobile health intervention

KW - blended care

KW - clinical staging

KW - digital intervention

KW - public mental health

KW - Clinical staging

KW - Mobile health (mHealth) intervention

KW - Digital intervention

KW - Blended care

KW - Public mental health

UR - https://www.scopus.com/pages/publications/85166637627

U2 - 10.1016/j.brat.2023.104367

DO - 10.1016/j.brat.2023.104367

M3 - Article

C2 - 37467549

SN - 0005-7967

VL - 168

JO - Behaviour Research and Therapy

JF - Behaviour Research and Therapy

M1 - 104367

ER -