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Change of self-schemas following mindfulness-based compassionate living for recurrent depression: A qualitative study.

Vera Scheepbouwer, Imke Hanssen, Rhoda Schuling, Marloes J. Huijbers, Guusje Collin, Gerben J Westerhof, Anne E. M. Speckens

Acta Psychologica June 15, 2026 DOI: 10.1016/j.actpsy.2026.107183 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Qualitative study (mixed-methods analysis within a randomized controlled trial) Peer reviewed
Sample size 24
Population Patients with depression who completed Mindfulness-Based Compassionate Living (MBCL) treatment
Intervention Mindfulness-Based Compassionate Living (MBCL)
Measures self-description interviews, Five Factor Model, Linguistic Inquiry and Word Count (LIWC)
Topics Depression Meditation
Keywords Humans Recurrence Empathy Self concept Qualitative research Adult Middle aged Female Linguistics Self-schemas Self-compassion
Key findings The authors report that after MBCL, patients' self-descriptions shifted from neuroticism toward emotional stability, from self-criticism toward self-compassion, and from self-sacrificing care for others toward a more balanced approach, alongside decreased agreeableness. Language analysis showed more words overall but fewer positive-emotion and cognitive-process words. They conclude MBCL appears associated with changes in self-schemas and interpersonal dynamics, while noting methodological limitations.

Abstract

Objectives: Compassion-based interventions, like Mindfulness-Based Compassionate Living (MBCL), are increasingly recognized as treatments for depression. This study explores the impact of MBCL on self-schemas.

Methods: As part of an RCT on MBCL for depression, self-description interviews of approximately 3 min in duration were conducted with 24 patients before and after MBCL and were analyzed using mixed methods. Qualitative analysis used both a deductive approach (based on the Five Factor Model) to identify themes and an inductive approach to explore subthemes within those themes. Additionally, Linguistic Inquiry and Word Count (LIWC) software analyzed words in psychologically relevant categories.

Results: Deductive analysis revealed a shift from neuroticism to emotional stability and a decrease in agreeableness. Inductive analysis highlighted a transition from self-criticism to self-compassion, and a shift from prioritizing others 'needs at the expense of self-care to a more balanced approach. LIWC analysis indicated that post-MBCL, patients used more words overall (W = 2.8; p = 0.006), but fewer positive emotion words (W = -3.1; p = 0.002) and fewer words related to cognitive processes (W = -2.6; p = 0.009).

Conclusions: MBCL appears to be associated with changes in self-schemas and interpersonal dynamics, providing insights for future (linguistic) studies on the mechanisms of MBCL. These findings should be carefully interpreted considering the methodological limitations of the current investigation, including differing pre- and post-interview prompts and a sample of treatment completers.

Comparable studies

Other randomized controlled trials on depression, most cited first.

Study Year Design Participants
A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression Subjects with DSM-IV major depression (treatment resistant) 2006 Randomized, placebo-controlled, double-blind crossover study n = 18
Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients 2000 Randomized controlled trial n = 145
Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Cancer patients with life-threatening diagnoses and symptoms of depression and/or anxiety 2016 Randomized controlled trial n = 51
Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Patients with cancer-related anxiety and depression 2016 Double-blind, placebo-controlled, crossover trial n = 29
Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients 2004 Randomized controlled trial n = 73

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