Evaluation of a Self-compassion App in People With Cancer: Feasibility, Acceptability and Changes in Well-being

To support patients with cancer with managing psychological distress due to their illness and treatment, a self-help digital Compassionate Mind Training (i.e., Compas-Y App) was developed in co-creation with people with cancer and nurses in oncology.

This study will examine : What is the feasibility, acceptability, and effectiveness of Compas-Y app in distressed cancer patients? The reseachers use a multiple baseline design, with a 2-3 week baseline phase and a 6-week intervention phase.

Adult patients (>= 18 years) will be approached for the study, who finished their medical treatment and who experience a reduced well-being.

To examine the effects of Compas-Y, the researchers will examine changes in self-compassion and self-criticism (primary outcomes) and mindfulness, emotion regulation strategies, and positive and negative affect (secondary outcomes). We will use EMA items to assess momentary levels of these primary and secondary outcomes.

These assessments will be 3 times per week at 7:00 PM, both during the 2-3 week baseline phase ( 6-9 assessments in total) and the 6-week intervention phase (18 times assessments in total).

The expectation is increases in self-compassion, reductions in self-criticism, and improved affect as well as improved mindfulness and emotion regulation. In addition, the expectation is more improvement in outcomes in those patients with greater usage of the app.

Study Overview

• Status: Completed
• Conditions: Cancer
• Intervention / Treatment: Other: A digital self-help self-compassion app intervention

• Study Type: Interventional
• Enrollment (Actual): 28
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Netherlands
  • Groningen, Netherlands, 9713 AV
    • Department of Health Sciences, Health Psychology Section, University Medical Center Groningen

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion criteria:

1. aged 18 and older;
2. Diagnosed with cancer (stage I-III);
3. Completed medical treatment in the past 2 years;
4. Reporting a reduced well-being (Mental Health Inventory (MHI-5) = <76 score (Kelly et al., 2008) [lower scores indicate worse well-being]);
5. Proficient in Dutch;
6. willing to try out the app for about 2 hours per week during 6 weeks and fill in the questionnaires for 8-10 weeks;

7. Participants should have a smartphone, computer or tablet with internet access for digital intervention and data-collection.

   • Exclusion criteria:

1. Participants have a current psychological or psychiatric treatment outside this study. 2. Insufficient Dutch language skills to follow the group sessions or complete homework exercises

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Digital self-help self-compassion app (Compas-Y); 6-week self-help app intervention	Other: A digital self-help self-compassion app intervention; A 6 week self-help self-compassion app intervention providing psychoeducation and brief exercises via the app

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self-compassion	Momentary self-compassion is assessed using ecological momentary assessment (EMA) items. We use five items based on the Sussex-Oxford Compassion for the Self Scale (SOCS-S), with each of the five facets of self-compassion covered by one EMA item: (1) "I'm quick to notice early signs of distress in myself.", (2) "I understand that feeling upset at times is part of human nature.", (3) "I feel kindly towards myself.", (4) "I connect with my own suffering without judging myself.", (5) "I try to look after myself." Items are rated on a 0-100 visual analogue scale with verbal anchors (0 = "Not at all," 25 = "A little," 50 = "Moderately," 75 = "Quite a bit," 100 = "Very much").	During baseline period, participants fill out 3 assessments each week on Tuesday, Thursday and Saturday at 7.00 PM for 2 to 3 weeks (depending on randomisation). During the 6-week intervention, they will fill out 3 assessments each week.
Self-criticims	Momentary self-criticism is assessed with a single item derived from the Self-Compassion Scale: "I am a bit cold-hearted towards myself when I'm experiencing suffering", rated on a 0-100 visual analogue scale with verbal anchors (0 = "Not at all," 25 = "A little," 50 = "Moderately," 75 = "Quite a bit," 100 = "Very much").	During baseline period, participants fill out 3 assessments each week on Tuesday, Thursday and Saturday at 7.00 PM for 2 to 3 weeks (depending on randomisation). During the 6-week intervention, they will fill out 3 assessments each week.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mindfulness	Mindfulness is assessed with two validated momentary assessments items from the platform HowNutsAreTheDutch: (1) "I did activities automatically, without being aware of what I was doing"; (2) "I was easily distracted". Both items are rated on 0-100 scale (0 = "Not at all," 25 = "A little," 50 = "Moderately," 75 = "Quite a bit," 100 = "Very much").	During baseline period, participants fill out 3 assessments each week on Tuesday, Thursday and Saturday at 7.00 PM for 2 to 3 weeks (depending on randomisation). During the 6-week intervention, they will fill out 3 assessments each week.
Affect	Affect is assessed with eight items from the platform HowNutsAreTheDutch. Four items for Positive affect: "I feel excited/relaxed/satisfied/energetic". Four items for Negative affect: "I feel anxious/down/irritable/tired". All items are rated on 0-100 scale (0 = "Not at all," 25 = "A little," 50 = "Moderately," 75 = "Quite a bit," 100 = "Very much").	During baseline period, participants fill out 3 assessments each week on Tuesday, Thursday and Saturday at 7.00 PM for 2 to 3 weeks (depending on randomisation). During the 6-week intervention, they will fill out 3 assessments each week.
Emotion regulation	Emotion Regulation is assessed by four items from existing validated questionnaires adapted for momentary assessment. For all four items the stem is: "Today when unpleasant thoughts came to me .... The items are: "I think that I have to accept the situation (Cognitive Emotion Regulation Questionnaire (CERQ), acceptance subscale), "I think I can learn something from the situation" (CERQ, positive reappraisal subscale), "I am preoccupied with what I think and feel about what I have experienced" (CERQ, rumination subscale), "I try to put them out of my mind" (Multidimensional Experiential Avoidance Questionnaire, avoidance subscale). The four items are rated on 0-100 scale (0 = "Not at all," 25 = "A little," 50 = "Moderately," 75 = "Quite a bit," 100 = "Very much").	During baseline period, participants fill out 3 assessments each week on Tuesday, Thursday and Saturday at 7.00 PM for 2 to 3 weeks (depending on randomisation). During the 6-week intervention, they will fill out 3 assessments each week.

Collaborators and Investigators

• Sponsor: University Medical Center Groningen
• Investigators: Principal Investigator: Ernst Bohlmeijer, Prof. dr., Twente University Department of Psychology

Publications and helpful links

General Publications

• Austin J, Drossaert CHC, Schroevers MJ, Sanderman R, Kirby JN, Bohlmeijer ET. Compassion-based interventions for people with long-term physical conditions: a mixed methods systematic review. Psychol Health. 2021;36(1):16-42. doi:10.1080/08870446.2019.1699090
• Austin J, Drossaert CHC, van Dijk J, et al. Integrating Top-down and Bottom-up Requirements in eHealth Development: The Case of a Mobile Self-compassion Intervention for People With Newly Diagnosed Cancer. JMIR Cancer. 2022;8(3):e37502. Published 2022 Aug 1. doi:10.2196/37502
• Austin J, Schroevers MJ, Van Dijk J, et al. Compas-Y: A mixed methods pilot evaluation of a mobile self-compassion training for people with newly diagnosed cancer. Digit Health. 2023;9:20552076231205272. Published 2023 Oct 19. doi:10.1177/20552076231205272

Study record dates

Study Major Dates

• Study Start (Actual): April 27, 2024
• Primary Completion (Actual): September 1, 2024
• Study Completion (Actual): May 1, 2025

Study Registration Dates

• First Submitted: December 12, 2025
• First Submitted That Met QC Criteria: February 9, 2026
• First Posted (Actual): February 17, 2026

Study Record Updates

• Last Update Posted (Actual): February 17, 2026
• Last Update Submitted That Met QC Criteria: February 9, 2026
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: App; Emotion Regulation; Intervention; Self-help; Compassion; Self-compassion; Self-criticism; EMA assessment
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Mental Disorders; Neurocognitive Disorders; Dementia; Tauopathies; Neurodegenerative Diseases; Behavior; Social Behavior; Self-Control; Neoplasms; Alzheimer Disease; Emotional Regulation
• Other Study ID Numbers: 17009

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Meta data will be put on the official Groningen University Data Repository to inform researchers about the data and support open science
• IPD Sharing Access Criteria: Meta data accessible via the University Research Portal
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No