Breath-Focused Mindfulness and Compassion Training in Parent-Child Dyads: Pilot Intervention Study

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.

This scenario highlights the urgent need for the development and implementation of accessible and scalable solutions that may cobenefit child and parent mental well-being.

This pilot study introduced "Cooperative Compassion" (CoCo), a parent-child cotraining 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, SD 3.27 years; female: n=14, male: n=10; Asian: n=5, White: n=11, mixed race: n=7, other race: n=1; and parents' mean age 44.5, SD 6.5 years; 20 female: n=20, male: n=4; Asian: n=8, White: n=14, mixed race: n=2) of high average affluence socioeconomic scores participated in the study. These parent-child dyads completed 30 sessions of CoCo training over 3 months with baseline and postintervention assessments occurring within 2 weeks of training initiation or completion, respectively.

The program was feasible, with 80% (n=19) of families completing over 90% (n=22) of sessions and providing positive feedback. Mental health assessments showed a nonsignificant effect in the expected direction in children's depression scores (Cohen d=-0.19; 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 (ρ=-0.45; P=.03). On an emotion bias task used as an objective assessment of cognition, children demonstrated improved processing speed after the intervention (d=0.54; 95% CI 0.012-0.083; P=.005), and a marginal improvement was also observed in parents (d=0.19; 95% CI -0.004 to 0.030; P=.05). Cortical source imaging of electroencephalographic recordings was acquired simultaneous to an attention-to-breathing assessment that showed significant reduction in task-related default mode network activity (d=-0.62; 95% CI -0.0096 to -0.0002; P=.01).

Post-CoCo intervention decrease in default mode network 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 cotraining to improve family mental health and well-being.