JMIR Publications

ABSTRACT

Childhood depression is a significant mental health concern that impacts both children and their parents. This study introduced "Cooperative Compassion" (CoCo), a parent-child co-training digital application aimed at promoting mindfulness and compassion through 10-minute, performance-adaptive sessions. A total of 24 parent-child dyads (children’s mean age: 9.5 years, parents’ mean age: 44.5 years) completed up to 30 sessions over three months. The program was feasible, with 80% of families completing over 90% of sessions and providing positive feedback. Mental health assessments showed a trend towards improvement in children’s depression scores (Cohen’s d=-0.19, p=0.07) and significant reductions in parental stress (d=-0.41, p=0.02), anxiety (d=-0.47, p=0.02), and depression (d=-0.50, p=0.03), with sustained benefits at the 3-month follow-up. Parental mindfulness improvements were correlated with stress reduction (rho=-0.45, p=0.03). On an emotion bias task utilized as an objective assessment of cognition, children also demonstrated improved processing speed post-intervention (d=0.54, p=0.005), and a marginal improvement in parents (d= 0.19, p=0.05). Cortical source imaging of EEG recordings acquired simultaneous to an attention-to-breath assessment showed significant reduction in task-related default mode network (DMN) activity across all participants (d=-0.62, p=0.01). These findings highlight the potential of brief, digital mindfulness and compassion co-training to enhance family mental health and well-being.