The Effectiveness and Acceptability of Formal Versus Informal Mindful Self-Compassion for Adolescents

Formal Versus Informal Mindful Self-Compassion Programming for Adolescents

The goal of this clinical trial is to learn if two types of mindful self-compassion programs work to improve coping in adolescents. The investigators will also learn about adolescents' liking of, and the other potential mental health and academic benefits of, these programs. The main questions this clinical trial aims to answer are:

• Do two types of mindful self-compassion programs improve coping in adolescents?
• Do two types of mindful self-compassion programs improve mental health (e.g., stress, anxiety, depression) and academic outcomes (e.g., academic engagement) in adolescents?
• How satisfactory are two types of mindful self-compassion programs for adolescents?

To do this, the investigators will compare adolescents who complete two types of mindful self-compassion programs to adolescents in a "waitlist control" condition (who complete no study tasks during the program period, but will have the opportunity to complete the program at the end of the study).

Participants will:

• Complete a brief phone interview to confirm their eligibility (15 min)
• Complete an online survey including questions about coping, mental health, and academic engagement (30 min)
• Complete a live, online, four-week-long mindful self-compassion program OR no study tasks during this four-week period (if randomly assigned to a waitlist condition)
• Complete an online survey 1 week after the 4-week period, including questions about coping, mental health, and academic engagement, as well as their liking of the program they completed (if applicable)
• Complete an online survey 1 month after the 4-week period, including questions about coping, mental health, and academic engagement
• (Waitlist condition only) Have the opportunity to complete one of the two mindful self-compassion programs after the study had ended

Study Overview

• Status: Recruiting
• Conditions: Coping
• Intervention / Treatment: Behavioral: Formal Mindful Self-Compassion (MSC-F); Behavioral: Informal Mindful Self-Compassion (MSC-I)

Detailed Description

Background

Over the past decade, increasing smartphone and social media usage have magnified social pressures among adolescents. In turn, these youth report heightened stress and self-criticism, and often turn to unhealthy coping behaviors (e.g., substance use, disordered eating, self-injury) that can become life-threatening, making this a critical issue in youth mental health. Emerging evidence suggests that group-based mindful self-compassion (MSC) interventions may improve adolescents' mental health and encourage their use of healthy coping behaviors. However, challenges persist regarding adherence to standard length (i.e., eight-week) programs and low engagement with formal mindfulness practice (e.g., meditation) among adolescents; briefer programs and a focus on informal practice may be better tolerated and more effective. The aims of the proposed hybrid 1 effectiveness-implementation randomized clinical trial (RCT) are thus to compare the effectiveness and acceptability of four-week-long formal (MSC-F) versus informal (MSC-I) MSC interventions for adolescents, relative to a waitlist control condition.

Procedure

Prior to administering a screening questionnaire, the project director (PD; Julia Petrovic) will contact the prospective participant's parent by phone (or the participant directly if 18-19 years old) to describe the study and conduct a pre-screen with inclusion/exclusion criteria. If the adolescent is deemed to be potentially eligible, a call will be scheduled with the applicant, parent (if required), and adolescent to review and sign the informed consent/assent forms together over the phone or a Zoom/Google Meet HIPAA-compliant videoconference call. After informed consent/assent have been obtained, adolescents will complete a brief phone interview to confirm their eligibility.

Eligible adolescents will then be randomized, stratified by gender, to one of three trial arms with a 1:1:1 allocation ratio: MSC-F, MSC-I, or waitlist control. The PD will conduct the randomization and inform participants and their parents (if <18 years) of their assigned condition via email (as well as share group session scheduling information if assigned to the MSC-F or MSC-I conditions). Shortly after this email has been sent, the PD will call the parents/participants to ensure that the information was received and confirm the scheduled MSC group session dates/times.

The duration of the study period for participants in all three trial arms is 9 weeks. All participants will complete a 30-minute survey battery (baseline/Week 0). Participants in the MSC-F and MSC-I conditions will then complete their assigned interventions over the course of four weeks (Weeks 1-4) while those in the waitlist control condition do not complete any study tasks. Participants in the MSC-F and MSC-I conditions will also complete weekly home practice surveys from Weeks 2-5 (i.e., one following each week of the program). Participants in all three study arms will then complete a 30-minute survey battery 1 week (Week 5) and 1 month (Week 8) after the intervention period.

At the end of the study period, participants assigned to the waitlist control condition will be invited to complete one of the two MSC interventions.

All study procedures will be conducted virtually through phone/email, videoconference, and the secure REDCap survey platform.

• Study Type: Interventional
• Enrollment (Estimated): 135
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Frannie Marin, BS; Phone Number: 617-643-8770; Email: fmarin@challiance.org
• Study Contact Backup: Name: Julia Petrovic, PhD; Phone Number: 781-605-4429; Email: mscteen@challiance.org

Study Locations

• United States
  • Massachusetts
    • Malden, Massachusetts, United States, 02148
      • Recruiting
      • Center for Mindfulness and Compassion
      • Contact: Julia Petrovic, PhD; Phone Number: 781-605-4429; Email: mscteen@challiance.org

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Be 14-19 years of age for the duration of the study;
• If 14-17 years of age: have a parent with sufficient literacy skills to understand the consent process and have the ability to provide written informed consent, and have sufficient English fluency and literacy skills themselves to understand the assent process, procedures, and questionnaires and have the ability to provide written assent;
• If 18-19 years of age: have sufficient English fluency and literacy skills themselves to understand the consent process, procedures, and questionnaires and have the ability to provide written informed consent;
• Have access to the internet and an electronic device with adequate data capacity to complete questionnaires online and attend online videoconference groups;
• Be available and willing to attend the scheduled online videoconference groups for 4 weeks and complete the online assessments.

Exclusion Criteria:

• Current or past-year treatment with mindfulness-based psychotherapy (e.g., MBCT, DBT, or ACT);
• Current or past-year participation in a mindfulness- or compassion-based program;
• A routine of, on average, 10 minutes of mindfulness practice per day over the past 30 days (greater than or equal to 300 minutes);
• Simultaneous participation in another experimental research study;
• Current or past-year diagnosis of: schizophrenia spectrum or other psychotic disorder, bipolar 1 disorder, or severe substance/alcohol use disorder;
• Current or past-month suicidal ideation;
• Hospitalization for reasons related to mental health within the past 6 months;
• Recent modifications to psychiatric medication(s) (within the last 30 days or within the last 90 days for antidepressants (e.g., SSRI, SNRI, etc.);
• Inability to complete consent/assent process or baseline assessment.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Formal Mindful Self-Compassion (MSC-F); Participants assigned to the MSC-F condition (n=45) will complete a four-week-long live online mindful self-compassion program, which will include the instruction of formal practices (e.g., guided meditations).	Behavioral: Formal Mindful Self-Compassion (MSC-F); The MSC-F and MSC-I programs will be adaptations of the Mindful Self-Compassion - Teen (MSC-T) program (formerly Making Friends With Yourself; Bluth et al., 2016). MSC-T includes the instruction of both formal and informal practices; the adapted programs will thus disentangle the two approaches to allow for their direct comparison. The adapted MSC-F and MSC-I programs will comprise weekly hour-long virtual group sessions held over four weeks and led in real time by IRB-approved CHA researchers and clinicians. Each session will include (i) psychoeducation related to stress, mindfulness, self-compassion, and healthy/unhealthy coping, (ii) in-session mindfulness practice, and (iii) group discussion. Content will be identical across the MSC-F and MSC-I programs aside from the specific practices taught (i.e., whether exclusively formal or informal). Weekly home practice will be assigned and supporting handouts and audio files (where applicable) will be shared following each session.
Experimental: Informal Mindful Self-Compassion (MSC-I); Participants assigned to the MSC-I condition (n=45) will complete a four-week-long live online mindful self-compassion program, which will include the instruction of informal practices (e.g., noticing day-to-day sensory experiences with mindful self-compassion).	Behavioral: Informal Mindful Self-Compassion (MSC-I); The MSC-F and MSC-I programs will be adaptations of the Mindful Self-Compassion - Teen (MSC-T) program (formerly Making Friends With Yourself; Bluth et al., 2016). MSC-T includes the instruction of both formal and informal practices; the adapted programs will thus disentangle the two approaches to allow for their direct comparison. The adapted MSC-F and MSC-I programs will comprise weekly hour-long virtual group sessions held over four weeks and led in real time by IRB-approved CHA researchers and clinicians. Each session will include (i) psychoeducation related to stress, mindfulness, self-compassion, and healthy/unhealthy coping, (ii) in-session mindfulness practice, and (iii) group discussion. Content will be identical across the MSC-F and MSC-I programs aside from the specific practices taught (i.e., whether exclusively formal or informal). Weekly home practice will be assigned and supporting handouts and audio files (where applicable) will be shared following each session.
No Intervention: Waitlist Control; Participants assigned to the waitlist control condition (n=45) will complete no study tasks during the 4-week intervention period, during which participants assigned to the MSC-F and MSC-I conditions complete their assigned programs. These waitlist control participants will be invited to complete one of the two programs at the end of the 9-week study period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Coping Index (CI)	The Coping Index (CI; Stallman, 2017) is a 20-item self-report measure of healthy (10 items) and unhealthy (10 items) coping behaviors based on the Health Theory of Coping (Stallman, 2020). Respondents rate how often they use each behavior to feel better when they are feeling stressed or distressed using a 4-point Likert scale ranging from I do not do this at all (0) to I do this most of the time (3). The item, 'Have thoughts about suicide', will be omitted for the purposes of this study; an adapted 19-item version of the CI will therefore be used. A coping index score will be computed, which is the healthy subscale mean minus the unhealthy subscale mean (possible range: 3 to -3). A higher score reflects a better outcome.	5 weeks (From baseline to 1 week post-intervention)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Coping Index (CI)	The Coping Index (CI; Stallman, 2017) is a 20-item self-report measure of healthy (10 items) and unhealthy (10 items) coping behaviors based on the Health Theory of Coping (Stallman, 2020). Respondents rate how often they use each behavior to feel better when they are feeling stressed or distressed using a 4-point Likert scale ranging from I do not do this at all (0) to I do this most of the time (3). The item, 'Have thoughts about suicide', will be omitted for the purposes of this study; an adapted 19-item version of the CI will therefore be used. A coping index score will be computed, which is the healthy subscale mean minus the unhealthy subscale mean (possible range: 3 to -3). A higher score reflects a better outcome.	9 weeks (From baseline to 1 month post-intervention)
18-item Five Facets of Mindfulness Questionnaire (FFMQ-18)	The 18-item Five Facets of Mindfulness Questionnaire (FFMQ-18; Medvedev et al., 2018) is a self-report measure of dispositional (i.e., trait) mindfulness. It consists of five subscales, each reflecting one facet of mindfulness (acting with awareness, nonjudgmental acceptance, nonreactivity, observing, and describing). Items are rated on a 5-point Likert scale ranging from Never or very rarely true (1) to Very often or always true (5). The FFMQ-18 is the most reliable and valid short form of the full-scale (39-item) FFMQ (Medvedev et al., 2018). A global mean will be computed (possible range: 1 to 5) whereby a higher score reflects a better outcome.	5 weeks and 9 weeks (From baseline to 1 week and 1 month post-intervention)
Self-Compassion Scale - Short Form (SCS-SF)	The Self-Compassion Scale - Short Form (SCS-SF; Raes et al., 2011) is a 12-item self-report measure of self-compassion. Respondents are asked to indicate how often they behave in the stated manner using a 5-point Likert scale ranging from Almost never (1) to Almost always (5). The SCS-SF has a near-perfect correlation with the full-scale SCS and is a reliable alternative when assessing overall self-compassion (Raes et al., 2011). A global mean will be computed (possible range: 1 to 5) whereby a higher score reflects a better outcome.	5 weeks and 9 weeks (From baseline to 1 week and 1 month post-intervention)
Perceived Stress Scale (PSS)	The Perceived Stress Scale (PSS; Cohen et al., 1983) is a 10-item self-report measure of perceived stress. Respondents are asked to rate each item on a 5-point Likert scale (0 = Never to 4 = Very often) based on how often they feel or think a certain away. A sum score will be computed (possible range: 0 to 40) whereby a higher score reflects a worse outcome.	5 weeks and 9 weeks (From baseline to 1 week and 1 month post-intervention)
Generalized Anxiety Disorder (GAD-7) scale	The Generalized Anxiety Disorder scale (GAD-7; Spitzer et al., 2006) is a widely used 7-item self-report measure of anxiety. Respondents are prompted to indicate using a 4-point Likert scale ranging from Not at all (0) to Nearly every day (3) how often they experienced each anxiety symptom listed over the past two weeks. A sum score will be computed (possible range: 0 to 21) whereby a higher score reflects a worse outcome.	5 weeks and 9 weeks (From baseline to 1 week and 1 month post-intervention)
Patient Health Questionnaire - Modified for Adolescents (PHQ-A)	The Patient Health Questionnaire - Modified for Adolescents (PHQ-A; Johnson, 2002) is a 9-item self-report measure of depression for adolescents, adapted from the widely-used adult version. Respondents are asked to indicate how often they experienced each depressive symptom listed over the past two weeks using a 4-point Likert scale ranging from Not at all (0) to Nearly every day (3). The item, 'Thoughts that you would be better off dead, or of hurting yourself in some way?', will be omitted for the purposes of this study; an adapted 8-item version of the PHQ-A will therefore be used. A sum score will be computed (possible range: 0 to 24) whereby a higher score reflects a worse outcome.	5 weeks and 9 weeks (From baseline to 1 week and 1 month post-intervention)
Theoretical Framework of Acceptability (TFA) questionnaire	The Theoretical Framework of Acceptability questionnaire (TFA; Sekhon et al., 2022) is an 8-item self-report measure of intervention acceptability that will only be administered 1-week post-intervention to those in the MSC-F and MSC-I conditions. The TFA questionnaire is adaptable and can be used to evaluate a variety of healthcare interventions (including mental healthcare). It consists of seven items, each pertaining to one of the components listed above, as well as an eighth item that assesses general acceptability. Items are rated on 5-point Likert scales (with varying labels depending on the item). A global mean will be computed (possible range: 1 to 5) whereby a higher score reflects a better outcome. In addition, 5 researcher-developed, follow-up open-ended questions will be asked at the end of the TFA to obtain more detailed information regarding intervention acceptability (e.g., What did you like the most about the program?).	5 weeks (From baseline to 1 week post-intervention)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Home Practice Survey	A brief researcher-developed Home Practice Survey will be used to assess, on a weekly basis, the amount of independent mindfulness practice participants complete throughout the 4-week intervention period. This measure consists of 2-4 items (depending on participants' responses) which ask about participants' frequency of practice and specific practices used over the last week.	4 weeks (Week 2, 3, and 4 of intervention and 1 week post-intervention)
Self-Oriented Perfectionism subscale of the Multidimensional Perfectionism Scale (MPS)	The Self-Oriented Perfectionism subscale of the Multidimensional Perfectionism Scale (MPS; Hewitt & Flett, 1991, 2004) is a 15-item measure of perfectionism. Respondents are asked to indicate their agreement with each item using a 7-point Likert scale ranging from Strongly disagree (1) to Strongly agree (7). A sum score will be computed (possible range: 15 to 105) whereby a higher score reflects a worse outcome.	5 weeks and 9 weeks (From baseline to 1 week and 1 month post-intervention)
Self-Critical Rumination Scale (SCRS)	The Self-Critical Rumination Scale (SCRS; Smart et al., 2016) is a 10-item self-report measure of self-critical rumination. Respondents are asked to indicate how well each item describes them using a 4-point Likert scale ranging from Not at all (1) to Very well (4). A global mean will be computed (possible range: 1 to 4) whereby a higher score reflects a worse outcome.	5 weeks and 9 weeks (From baseline to 1 week and 1 month post-intervention)
Difficulties in Emotion Regulation Scale - Short Form (DERS-SF)	The Difficulties in Emotion Regulation Scale - Short Form (DERS-SF; Kaufman et al., 2015) is an 18-item measure of emotion dysregulation. Respondents are asked to indicate how often each statement applies to them using a 5-point Likert scale ranging from Almost never (1) to Almost always (5). A sum score will be computed (possible range: 18 to 90) whereby a higher score reflects a worse outcome.	5 weeks and 9 weeks (From baseline to 1 week and 1 month post-intervention)
Utrecht Work Engagement Scale for Students (UWES-9S)	The Utrecht Work Engagement Scale for Students (UWES-9S; Schaufeli et al., 2002) is a 9-item self-report measure of academic engagement. Items are rated on a 7-point Likert scale ranging from Never (1) to Always/every day (7) based on the frequency with which the respondent experiences each statement. A global mean will be computed (possible range: 1 to 7) whereby a higher score reflects a better outcome.	5 weeks and 9 weeks (From baseline to 1 week and 1 month post-intervention)

Collaborators and Investigators

• Sponsor: Cambridge Health Alliance
• Investigators: Principal Investigator: Zev Schuman-Olivier, MD, Cambridge Health Alliance

Study record dates

Study Major Dates

• Study Start (Actual): April 13, 2026
• Primary Completion (Estimated): April 30, 2027
• Study Completion (Estimated): April 30, 2027

Study Registration Dates

• First Submitted: April 1, 2026
• First Submitted That Met QC Criteria: April 1, 2026
• First Posted (Actual): April 7, 2026

Study Record Updates

• Last Update Posted (Actual): April 20, 2026
• Last Update Submitted That Met QC Criteria: April 15, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: CHA-IRB-25-26-434

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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