Breath-focused mindfulness and compassion training in parent-child dyads: a pilot intervention study

Background: Depression in children is a concerning societal issue, and can
be associated with poor academic performance, school dropout and poor
overall quality of life. Additionally, child depression is often
associated with parallel stress and depression in parents. Objective: This
scenario highlights the urgent need for development and implementation of
accessible and scalable solutions that may co-benefit child and parent
mental well-being. Methods: This pilot study introduced "Cooperative
Compassion" (CoCo), a parent-child co-training digital application
aimed at promoting mindfulness and compassion through brief,
performance-adaptive sessions. A community sample of 24 parent-child dyads
(children’s mean age: 9.5 years, 14 females/10 males, 11 Caucasian/5
Asian/7 mixed race/1 other race; parents’ mean age: 44.5 years, 20
females/4 males, 14 Caucasian/8 Asian/2 mixed race) of high average
affluence socio-economic scores participated in the study. These
parent-child dyads completed 30 sessions of CoCo training over three
months with baseline and post-intervention assessments occurring within 2
weeks of training initiation/completion, respectively. Results: The
program was feasible, with 80% of families completing over 90% of sessions
and providing positive feedback. Mental health assessments showed a
non-significant effect in the expected direction in children’s depression
scores (Cohen’s d=-0.19, 95% Confidence Interval (95% CI) [-8.89 to 1.74],
P=.07) and significant reductions in parental stress (d=-0.41, 95% CI
[-2.63 to -0.16], P=.02), anxiety (d=-0.47, 95%  CI [-2.67 to
-0.20], P=.02), and depression (d=-0.50, 95% CI [-3.25 to -0.08], P=.03),
with sustained benefits at the 3-month follow-up. Parental mindfulness
improvements were correlated with stress reduction (rho=-0.45, P=.03). On
an emotion bias task utilized as an objective assessment of cognition,
children demonstrated improved processing speed post-intervention (d=0.54,
95% CI [0.011 to 0.088], P=.005), and a marginal improvement was also
observed in parents (d= 0.19, 95% CI [-0.006  to 0.031], P=.05).
Cortical source imaging of EEG recordings acquired simultaneous to an
attention-to-breathing assessment showed significant reduction in
task-related default mode network (DMN) activity (d=−0.53; 95% CI −0.0010
to −0.0003; P=.001). Conclusions: Post CoCo intervention decrease in DMN
activity on the attention-to-breath task in parent-child dyads may be
indicative of cortical plasticity reflecting reduced mind-wandering and
thereby, enhanced focus after training. The current promising behavioral
and cognitive results suggest the need for a larger sample size and a
randomized controlled study design. Overall, these findings highlight the
potential for brief, digital mindfulness and compassion co-training to
improve family mental health and well-being.