Self-Compassion and Resilience as Mediators of a 30-Day Internet-Delivered Mindfulness-Based Cognitive Therapy: A Pragmatic Open Trial

Abstract Objectives Emotional distress, encompassing stress, anxiety, and depression, is highly prevalent and associated with substantial personal and societal burden. While Mindfulness-Based Cognitive Therapy (MBCT) is an established intervention, its accessibility is often limited by program length, delivery format, and resource demands. Brief, minimally guided, internet-delivered MBCT (iMBCT) formats may offer a scalable alternative, but evidence for their effectiveness and mechanisms remains limited. This pragmatic two-arm open trial evaluated the feasibility and preliminary effects of a 30-day asynchronous iMBCT program in a community sample. The primary outcomes were reductions in perceived stress and emotional distress; secondary analyses examined whether self-compassion and resilience functioned as processes of change.

Methods: A total of 1,348 adults reporting emotional distress were allocated to either the iMBCT program or a waiting-list control (WLC). Due to high attrition, propensity score matching (PSM) was applied, yielding a final analytic sample of 190 individuals (91 iMBCT, 99 WLC). The intervention comprised six online MBCT sessions with audio-guided practices and psychoeducational materials.

Outcomes: (perceived stress, emotional distress, anxiety, depression, self-compassion, and resilience) were assessed at baseline and post-intervention. Analyses included mixed-model ANOVAs to evaluate group × time effects and mediation analyses (Hayes’ PROCESS, 10,000 bootstrap resamples) to test indirect effects through self-compassion and resilience.

Results: Compared with WLC, the iMBCT group showed significant reductions in perceived stress (η²p = .32, 95% CI [.21, .41]), emotional distress (η²p = .38, [.28, .47]), anxiety (η²p = .33, [.22, .42]), and depression (η²p = .34, [.24, .44]), alongside increases in self-compassion (η²p = .38, [.27, .47]) and resilience (η²p = .28, [.17, .37]). Mediation analyses indicated that improvements in self-compassion and resilience partially accounted for reductions in stress and distress, explaining 18–32% of the total effect across outcomes. The intervention experienced 67% attrition, and engagement metrics were not collected.

Conclusions: A brief, asynchronous iMBCT program can reduce self-reported stress, emotional distress, anxiety, and depression while enhancing self-compassion and resilience in a community sample. However, high attrition, reliance on self-report, and the absence of clinical diagnoses or follow-up limit generalizability and conclusions about long-term effects. Future studies should test such interventions in clinical populations, incorporate guided or synchronous elements to improve adherence, and collect objective engagement data to clarify dose–response relationships.