An Internet-Based Mindfulness- and Compassion-Based Intercare Program for Reducing Parental Burnout: Randomized
Francisco Javier Villalón López1,2, Maximiliano Escaffi-Schwarz3
1Centro de Educación Médica y Simulación Clínica (CEMSIC), Faculty of Medicine, Universidad Diego Portales, avenida Ejercito 141, Santiago, Santiago Metropolitan, Chile, 56 2 2676 2904.
Background:
Parental burnout is an underrecognized syndrome characterized by emotional exhaustion, detachment from children, and reduced parental efficacy. It is associated with sleep disturbance, addictive behaviors, suicidal ideation, and increased risk of child neglect and family conflict. Despite its public health relevance, evidence-based interventions remain limited, particularly in low- and middle-income contexts.
Objective:
This study aims to evaluate the efficacy and safety of a mindfulness- and compassion-based intercare program for parental burnout (IBAP-BP)-designed to reduce burnout symptoms in teleworking mothers.
Methods:
A 3-arm randomized controlled trial (IBAP-BP, active control, and waitlist) was conducted across Chile (December 2022-March 2023) with a 9-month follow-up. Participants (N=593) were women aged 18 years or older, teleworking ≥1 day/week, and living with at least 1 child. Exclusion criteria were self-reported severe psychiatric disorders. Randomization was computer-generated and centrally concealed; data analysts were blinded. The IBAP-BP group attended 8 weekly 2-hour internet-based sessions plus daily home practice integrating mindfulness and compassion. The active control performed relaxation and reflective journaling matched for duration and structure. The primary outcome was parental burnout at 9 months measured using the average-item score of the Parental Burnout Assessment; secondary outcomes were mindfulness, balance of risks/resources, and adverse effects. Modified intention-to-treat analyses and multilevel structural models assessed effects over time.
Results:
Of 593 randomized participants, 343 contributed at least 1 postbaseline assessment and comprised the modified intention-to-treat sample. At 9 months, the prespecified primary analysis showed greater reductions in parental burnout for IBAP-BP compared with the waitlist (mean difference=0.62, 95% CI 0.09-1.14; Cohen d≈0.6, 95% CI 0.41-0.77). No significant difference was found between IBAP-BP and the active control, which showed transient improvements up to 3 months. Effects remained robust in sensitivity analyses. Self-reported adverse events were rare and mild across IBAP-BP and active control. Mediation analyses showed inconsistent associations between mindfulness facets and outcomes.
Conclusions:
The culturally adapted, internet-based IBAP-BP program was feasible, safe, and effective compared with the waitlist condition for reducing parental burnout in working mothers, with effects sustained over 9 months, although it did not demonstrate superiority over the active control at the primary end point. Internet-based mindfulness- and compassion-based interventions may offer scalable, equitable options for preventing and treating parental burnout in resource-limited settings.
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