The Effects of Dialectical Behaviour Therapy Zen retreat on healthcare workers

The Effects of Dialectical Behaviour Therapy Zen retreat on healthcare workers | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Effects of Dialectical Behaviour Therapy Zen retreat on healthcare workers Karina Solovieff, Miguel Angel Murua, Maria Arqueros, Randy Wolbert, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7750231/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Dialectical Behavior Therapy (DBT) integrates mindfulness and dialectics, yet the contribution of a residential Zen-style mindfulness retreat for clinicians has seldom been evaluated. Methods We conducted a nonrandomized controlled study with 212 DBT-trained mental health professionals (Retreat = 120; Control = 92). The intervention was a 5-day, silent residential retreat with intensive formal and informal mindfulness practice; controls listened to daily Dharma, without meditation, over the same period. Self-report outcomes were assessed pre and post intervention. Results Relative to controls, the retreat produced greater increases in self-compassion areas such self-kindness (Δ = 0.87 vs 0.26, d = 0.43, p = .001), common humanity (0.97 vs − 0.12, d = 0.72, p < .001), and mindfulness (0.56 vs 0.01, d = 0.49, p < .001) and larger reductions in negative facets such self-judgment, isolation, over-identification (d = 0.34–0.61, all p ≤ .01). The retreat yielded greater reductions in depression (Δ = −3.15 vs − 0.33, d = 0.55, p < .001) and stress (− 6.78 vs − 0.80, d = 0.92, p < .001). Well-being increased more in the retreat across emotional, social, and psychological domains (d = 0.33–0.61, all p ≤ .012) and situational self-awareness increased substantially (Δ = 4.63 vs − 0.13, d = 0.71, p < .001). Conclusions A 5-day Zen mindfulness retreat produced clinically meaningful improvements both in clinical and wellbeing indexes beyond psychoeducation Dharma talks alone. Findings support the retreat as a beneficial component for DBT-practicing clinicians and could be a protentional promoting training component for DBT. Dialectical Behavior Therapy Zen Retreat Healthcare Workers Mindfulness Introduction Dialectical Behaviour Therapy (DBT) evolved as a synthesis of three paradigms: behaviourism, mindfulness and dialectics, synthesizing of cognitive-behavioural principles and Buddhist philosophy (Linehan, 1993a ) for treating Borderline Personality Disorder (BPD), currently DBT is the more empirically supported therapy for the most common specific Personality Disorder (Bohus et al. 2021 ). There is a direct connection in between the Mindfulness skills and Zen background, and this is probably the most recognizable part of the merge of both in this contextual therapy. But along with mindfulness, Radical Acceptance and Dialectics are also Zen based. Radical Acceptance encourages non-attachment to experience and see that " the essential world of perfection is this very world " (Wolbert, 2017 ) and Dialectics includes features such transcending dualistic thinking (e.g., subject-object distinctions) and promotes interconnection, transaction and the impermanence of any given experience (Soler et al. 2025 ). There is another facet even more intimately connected to Zen and frequently dismissed, the retreat. Meditation retreats (sesshins in the Zen tradition) are periods of intensive practice that take place in an environment of isolation from the influences of the world and during a break from usual activities, usually in a group format and guided by a teacher who transmits the Dharma teachings to the participants. It is a fundamental practice for those who have decided to deepen their meditation practice beyond the daily sessions for a relatively limited time. The author of the therapy, who also is a Zen master (Roshi), establish a five-day residential mindfulness retreat including daily formal and informal practices and rest periods. The program combines daily seated meditation, mindful walking practice, daily mindfulness talks (dharma talk) while participants maintain "noble silence" throughout the day. To incorporate mindfulness, acceptance and dialectics, beyond intellectual understanding, and being capable of effectively teaching those skills, having a personal mindfulness practice is stressed by Marsha Linehan. Indeed, she pointed attending to mindfulness Zen retreats to effectively get this goal (Linehan, 2014 ). Mindfulness is thought to be essential for DBT therapists, helps to flexibly balance acceptance and change, avoid distractions, cognitive distortions, and rigid rule adherence that hinder dialectical practice (Robins et al., 2002). Zen would help therapists maintain treatment focus in the case of highly complex patients, such as people with BPD, by noticing and contextualizing behaviours without judgment, better regulating therapist’s emotions in ongoing session, promote detachment from outcomes while keeping patient's goals in mind, fostering recognition and acceptance of personal and patient limitations, patient's inherent capabilities and phenomenological empathy (Lau & McMain 2005 ; Wolbert 2017 ). Although mindfulness and the acceptance component of DBT has been previously object of study and were already associated with increases non-judgemental stand, attention, emotional regulation and decentring and decreases BPD symptoms and impulsivity (Eeles et al. 2022; Elices et al., 2016 ; Carmona i Farrés et al., 2019 ; Schmidt et al. 2021 ; Soler et al. 2016 ). Although, research in dialectic component and Zen retreat in DBT is scarce (Sauer et al. 2011 ; Soler et al., 2025 ). In the case of the last, there is only one no controlled study from Razzaque & Wood ( 2016 ), testing a short Zen oriented retreat on 22 consultant psychiatrists. The retreat lasted 2 days and significantly reduced burnout and improved therapeutic alliance among psychiatrists. However, shortness, small sample size, and the absence of a control condition limit the generalizability of, these otherwise, promising results. The current study aims to respond unanswered questions about the unique contributions of this teaching component on therapeutic outcomes in DBT trained professionals working in a health care area. Healthcare workers are disproportionately affected by burnout, anxiety and compassion fatigue (Cocker & Joss 2016 ). The emotional demands of patient care, coupled with systemic pressures such as workload and bureaucratic constraints, have been pointed out to contribute to elevated rates of emotional distress across wide range of clinical settings (e.g., Weinberg, & Creed, 2000 ). Workplace stress has been linked to considerable number of negative outcomes, including reduced psychological well-being, lower quality of care, and reduced patient’s satisfaction. Preliminary studies on mindfulness-based interventions (MBIs) for healthcare professionals report moderate reductions in stress and improvements in well-being (Nutting et al., 2022 ; Khoury et al., 2017 ; Burton et al., 2017 ). Retreats offer a unique environment for sustained practice, free from daily distractions, which may amplify mindfulness’s benefits by deepening self-awareness and emotional regulation. Retreats have shown to enhance attentional control, reduce rumination, and increase self-compassion in variety of samples (Khoury et al., 2017 ). Shapiro et al., 2006 , considers mindfulness training offers a method of systematic self-care that may prevent therapist burnout and compassion fatigue. The rationale is grounded in empirical evidence demonstrating the capacity of mindfulness to reduce stress, enhance well-being, and cultivate self-compassion and posit that compassion for others is based upon one's own self-compassion. Empathic resonance (i.e., warmth, understanding, compassion), being able to be present and attentive have been identified as essential therapist skills for attending to clients’ needs to successfully conduct the treatment (Greenberg et al., 2001 ; Lambert & Barley, 2002 ). In randomized, controlled, double-blind study therapist intervention group was instructed in daily Zen meditation and practiced before the workday began showed that mindfulness meditation taught to therapists may have the potential to positively influence treatment outcomes in clients (Grepmair et al., 2007 ). An intensive mode of mindfulness training would have the potential to have similar or better effects in a shorter time compared to a MBIs program and stand to benefit from combine DBT’s pragmatic skills with Zen’s emphasis on self-compassion and interconnectedness. Methods Participants The study included a non-probabilistic, convenience sample of 212 mental health professionals (79.1% female) aged 26 to 77 years (M = 47.45, SD = 12.40). Participants were allocated to either the experimental group (n = 120) or the control group (n = 92), who were drawn from a waitlist. According to inclusion criteria, eligible participants were U.S. citizens aged 26–80 who were mental health professionals (e.g., psychologists, psychiatrists/physicians in mental health, or clinical social workers), had prior DBT training, provided written informed consent, data were collected anonymously and agreed to retreat community guidelines, although participants were encouraged to read recommended materials. Exclusion criteria were ongoing psychoactive substance use, acute psychotic episode at enrollment, or active communicable illness at the time of the retreat. One participant had missing group assignment data and was excluded from group comparisons. Experimental Condition People allocated in this branch attended a five-day intensive mindfulness retreat (DBT-based). They will practice different formal and informal Mindfulness practices. Each day will have rest periods of approximately one and a half hours. Throughout each of the days there will be four blocks of seated meditation practice (sunrise, pre-noon, early afternoon and sunset). Each of these blocks will be divided into 25-minute periods, with mindful walking practice (5–7 minutes) between each block. In addition to the short walks between the periods of sitting meditation practice, a daily 15-minute walk will be taken before the start of the activities and another 30-minute walk in the afternoon. Through these activities, discipline and radical acceptance will be worked on. In the transitions from one type of practice to the other, the passage from stillness to movement and vice versa. Each day, at mid-morning, the facilitator will give a talk on Mindfulness and in the afternoon, there will be a question-and-answer period for one hour. With these only exceptions, absolute silence (noble silence) will be maintained from the beginning to the end of the intervention. It should be noted that each participant will have an individual interview with the facilitator in which he/she will explain his/her motivations and expectations. Those who wish to do so will have the possibility of coordinating other interviews. Throughout the retreat, participants were encouraged to observe sensations, emotions, and thoughts non-reactively and to repeatedly return their attention to the present moment. Control Group People allocated to this group were assessed for the same length of five-day period. Were instructed to listen to five Zen Dharma talks (one per day), offering the same psychoeducational component of the Experimental Condition but non meditation practices were required neither complaining with silence instruction, The psychoeducational talks were written and recorded by the intervention coordinator. Measures Mental Health Continuum – Short Form (MHC–SF) The MHC–SF (Keyes, 2002 ) is a 14-item self-report instrument that measures three domains of positive mental health: emotional well-being, social well-being, and psychological well-being. Items are rated on a 6-point Likert scale according to frequency experienced (from "Never" to "Every day"). Cronbach’s alpha in the present study was 0.94 for the total scale, and above 0.80 for each subscale. The scale has demonstrated robust construct validity, with confirmatory factor analyses supporting a three-factor structure (Keyes, 2002 ; Lamers et al., 2011 ). Convergent validity has been shown via significant correlations with subjective well-being and social functioning; discriminant validity analyses indicate that positive mental health and mental illness are distinct but related dimensions. Depression, Anxiety and Stress Scales – 21 item version (DASS-21) The DASS-21 (Lovibond & Lovibond, 1995 ) is a 21-item self-report questionnaire measuring depression, anxiety, and stress (7 items per subscale) over the past week. Items are rated on a 4-point Likert scale from 0 (“Did not apply to me at all”) to 3 (“Applied to me very much, or most of the time”). Subscale scores are summed and multiplied by two for comparability with the original 42-item version. In this study, Cronbach’s alpha for the total scale was 0.90; subscale reliabilities were α = .91 for depression, α = .80 for anxiety, and α = .84 for stress. Previous research has supported a three-factor structure (Henry & Crawford, 2005 ), and the DASS-21 is widely validated in Spanish populations. Situational Self-Awareness Scale (SSAS) The SSAS (Govern & Marsh, 2001) consists of 9 items measuring three facets of situational self-awareness: public, private, and environmental. Items are scored on a 7-point Likert scale from 1 (“Strongly disagree”) to 7 (“Strongly agree”), with instructions to respond based on “how you feel at this exact moment.” In the present study, Cronbach’s alpha for the total scale was 0.84. Factor-analytic studies support a three-factor structure. Subscale reliabilities reported in the literature are α = .82 (Public), .70 (Private), and .72 (Environmental); temporal stability (test-retest) ranges from r = .58 to .78. Self-Compassion Scale – Short Form (SCS–SF) The SCS–SF (Raes et al., 2011 ; Neff, 2003 ) is a 12-item self-report measure that assesses six dimensions of self-compassion, with two items per dimension: self-kindness, common humanity, mindfulness (positive dimensions); and self-judgment, isolation, and over-identification (negative dimensions). Items are rated from 1 (“Almost never”) to 5 (“Almost always”). Cronbach’s alpha in this study was 0.87 for the total scale. Subscale alphas in this sample were .86 for positive subscales (self-kindness, common humanity, mindfulness) and .76 for negative subscales (self-judgment, isolation, over-identification). The SCS–SF demonstrates strong psychometric properties, with confirmatory factor analysis supporting the six-factor model, and high convergent validity with the full 26-item version (Raes et al., 2011 ). Procedure The study was conducted with mental health professionals who voluntarily participated in a five-day residential mindfulness retreat (intervention group) or were assigned to a control group. The mindfulness retreat, as previously described, consisted of five consecutive days of intensive formal and informal mindfulness practice. The control group comprised professionals that did not attend the retreat but listened to one pre-recorded Dharma talk per day (written and recorded by the intervention facilitator) during the same period. Both groups were instructed not to engage in additional mindfulness practices or interventions during the study period. No randomization was performed. Self-report measures were completed electronically by all participants immediately before (pre) and after (post) the intervention period. Participation was anonymous and voluntary. Adherence was monitored through daily attendance records in the retreat group and confirmation of audio completion in the control group. The protocol was reviewed and approved by the Empty Cloud Sangha Research Committee (approval letter dated September 2, 2019). All participants provided written informed consent before any study procedure. The consent forms described study purpose, pre–post assessments, the control-condition instructions (listening to one Dharma talk per day), potential risks and lack of direct benefit, confidentiality safeguards (coded IDs, separation of identifiers, secure storage, and destruction after three years), and the voluntary nature of participation with the right to withdraw at any time; responses were collected anonymously. Data Analysis First, baseline differences between retreat and control groups were assessed. For continuous variables independent samples t -tests were used; for categorical variables, the chi-square test was applied. Variables showing significant baseline differences were identified for later adjustment. To evaluate within-group changes over time, paired samples t -tests were performed separately in the retreat and control groups for each outcome measure (pre- vs. post-intervention scores). Between-group differences in change scores (delta: post minus pre) were then compared using independent samples t -tests. For variables with significant baseline group differences, analysis of covariance (ANCOVA) was performed. In these models, post-intervention scores served as the dependent variable, group allocation (retreat vs. control) as the independent variable, and baseline scores as covariates. Effect sizes (Cohen’s d for t -tests, partial eta squared for ANCOVAs) were calculated for all primary outcomes. All statistical analyses were conducted using RStudio (R version 4.3.3). Table 1 Baseline Characteristics of the Sample Variable Retreat Group (n = 120) Control Group (n = 92) p-value Age (years) 48.88 (12.7) 45.71 (11.9) 0.058 % Female 74% (89/120) 91% (84/92) 0.078 Self-Compassion Scale ─ Self-Kindness 7.33 (1.67) 6.64 (1.90) 0.005** ─ Common Humanity 7.41 (1.65) 7.24 (1.93) 0.501 ─ Mindfulness 7.98 (1.22) 7.78 (1.39) 0.251 ─ Self-Judgment 5.19 (2.01) 5.67 (2.10) 0.091 ─ Isolation 5.12 (1.96) 5.71 (2.23) 0.041* ─ Over-Identification 5.52 (2.05) 5.82 (2.36) 0.320 ─ Positive Subscale 22.72 (3.75) 21.70 (4.36) 0.060 ─ Negative Subscale 15.82 (5.17) 17.20 (6.18) 0.070 DASS-21 ─ Depression 5.30 (6.19) 8.42 (8.38) 0.002** ─ Anxiety 7.02 (6.56) 6.67 (7.72) 0.722 ─ Stress 13.05 (7.13) 14.93 (8.60) 0.084 MHC-SF ─ Emotional Well-being 14.04 (2.74) 11.13 (2.85) < 0.001** ─ Social Well-being 18.77 (4.95) 14.58 (4.60) < 0.001** ─ Psychological Well-being 27.11 (5.80) 22.75 (4.64) < 0.001** Situational Self-Awareness Scale 37.24 (7.60) 42.01 (10.10) < 0.001** Table 1 displays the baseline sociodemographic and clinical characteristics of participants in the Retreat and Control groups. There were no statistically significant differences between groups in age or gender distribution. Regarding psychological measures, the Retreat group exhibited significantly higher self-kindness (p = .005), lower isolation (p = .041), and lower depression (p = .002) scores at baseline compared to the Control group. The Retreat group also demonstrated higher levels of emotional, social, and psychological well-being, as measured by the MHC-SF, and lower situational self-awareness (all p < .001). No significant group differences were observed for common humanity, mindfulness, self-judgment, over-identification, anxiety and stress at baseline. See Table 1 for detailed means and standard deviation Table 2. Pre–Post Changes within Groups (Paired t-tests), Effect Sizes, and Confidence Intervals Measure / Subscale Group n Mean Difference 95% CI t p-value Cohen’s d 95% CI (d) Self-Compassion Scale Self-kindness Retreat 120 -0.87 [-1.15, -0.58] -6.08 < .001 -0.54 [-0.73, -0.35] Control 92 -0.26 [-0.50, -0.02] -2.18 .031 -0.14 [-0.27, -0.01] Common humanity Retreat 120 -0.97 [-1.27, -0.66] -6.27 < .001 -0.61 [-0.81, -0.40] Control 92 0.12 [-0.13, 0.37] 0.95 .343 0.06 [-0.06, 0.18] Mindfulness Retreat 120 -0.56 [-0.79, -0.32] -4.72 < .001 -0.48 [-0.68, -0.27] Control 92 0.01 [-0.19, 0.21] 0.11 .913 0.01 [-0.13, 0.15] Self-judgment Retreat 120 0.83 [0.49, 1.16] 4.83 < .001 0.44 [0.25, 0.63] Control 92 0.26 [-0.00, 0.52] 1.96 .053 0.12 [0.00, 0.24] Isolation Retreat 120 1.11 [0.78, 1.44] 6.59 < .001 0.60 [0.41, 0.80] Control 92 0.15 [-0.08, 0.38] 1.33 .187 0.07 [-0.03, 0.17] Over-identification Retreat 120 1.33 [1.01, 1.65] 8.28 < .001 0.66 [0.49, 0.84] Control 92 0.41 [0.16, 0.67] 3.19 .002 0.18 [0.07, 0.29] SCS – Positive Retreat 120 -2.39 [-3.04, -1.75] -7.33 < .001 -0.66 [-0.86, -0.47] Control 92 -0.13 [-0.62, 0.36] -0.53 .597 -0.03 [-0.14, 0.08] SCS – Negative Retreat 120 3.27 [2.49, 4.04] 8.38 < .001 0.66 [0.49, 0.83] Control 92 0.83 [0.25, 1.40] 2.87 .005 0.13 [0.04, 0.23] DASS-21 Depression Retreat 120 3.15 [2.20, 4.10] 6.59 < .001 0.58 [0.39, 0.76] Control 92 0.33 [-0.69, 1.35] 0.63 .527 0.04 [-0.08, 0.16] Anxiety Retreat 120 2.25 [1.21, 3.29] 4.28 < .001 0.38 [0.20, 0.56] Control 92 1.00 [-0.09, 2.09] 1.82 .072 0.13 [-0.01, 0.27] Stress Retreat 120 6.78 [5.50, 8.07] 10.44 < .001 1.08 [0.82, 1.33] Control 92 0.80 [-0.33, 1.94] 1.40 .164 0.09 [-0.04, 0.22] MHC – Short Form Emotional Well-being Retreat 120 -0.76 [-1.13, -0.39] -4.04 < .001 -0.28 [-0.42, -0.14] Control 92 -0.18 [-0.43, 0.06] -1.47 .144 -0.06 [-0.15, 0.02] Social Well-being Retreat 120 -2.04 [-2.73, -1.35] -5.84 < .001 -0.41 [-0.55, -0.27] Control 92 -0.16 [-0.52, 0.19] -0.91 .365 -0.04 [-0.11, 0.04] Psychological Well-being Retreat 120 -2.03 [-2.78, -1.27] -5.33 < .001 -0.36 [-0.49, -0.22] Control 92 -0.32 [-0.72, 0.09] -1.54 .127 -0.07 [-0.15, 0.02] Situational Self-Awareness Scale SSAS – Total Retreat 120 -4.63 [-6.06, -3.19] -6.38 < .001 -0.64 [-0.86, -0.43] Control 92 0.13 [-0.79, 1.05] 0.28 .780 0.01 [-0.08, 0.10] According to Table 2, the retreat group, significant improvements were observed across most domains, including self-kindness, common humanity, mindfulness, and reductions in self-judgment and isolation (all p < .01, medium effect sizes). Notably, the retreat group showed a substantial decrease in stress (DASS-21), and improvements in all three domains of well-being (emotional, social, psychological) as measured by the MHC-SF. Similarly, large effect sizes were found for increases in positive self-compassion and reductions in negative self-compassion. In contrast, the Control group exhibited smaller or non-significant changes in most measures and limited change in most self-compassion and well-being dimensions (Cohen’s d mostly small). See Table 2 for full results. Table 3 Comparison of Pre-Post Change Scores (Δ) between Retreat and Control Groups Instrument / Variable ΔRetreat ΔControl 95% CI t p Cohen’s d 95% CI (d) Self-Compassion Scale (SCS-SF) Self-kindness 0.87 0.26 [0.24, 0.97] 3.26 .001 0.43 [0.16,0.71] Common humanity 0.97 -0.12 [0.69,1.48] 5.46 < .001 0.72 [0.44, 1.00] Mindfulness 0.56 0.01 [-0.87, -0.26] 3.68 < .001 0.49 [0.21,0.77] Self-judgment -0.83 -0.26 [-0.14, -0.99] -2.61 .010 -0.34 [ -0.62, -0.07] Isolation -1.11 -0.15 [-0.55, -1.36] -4.70 < .001 -0.61 [ -0.89, -0.33] Over-identification -1.33 -0.41 [-0.51, -1.33] -4.45 < .001 -0.59 [-0.87, -0.31] Positive SCS 2.39 0.13 [1.46, 3.07] 5.54 < .001 0.73 [0.45,1.01] Negative SCS -3.27 -0.83 [-1.48, -3.40] -5.03 < .001 -0.66 [-0.94, -0.38] Depression, Anxiety, Stress Scale (DASS-21) Depression -3.15 -0.33 [-1.44, -4.21] -4.02 < .001 -0.55 [-0.83,-0.28] Anxiety -2.25 -1.00 [0.25, -2.75] -1.64 .102 -0.23 [-0.50, -0.05] Stress -6.78 -0.80 [-4.27, -7.69] -6.90 < .001 -0.92 [-1.21, -0.64] MHC–Short Form Emotional well-being 0.76 0.18 [0.13, 1.02] 2.54 .012 0.33 [0.06, 0.60] Social well-being 2.04 0.16 [1.10,2.65] 4.79 < .001 0.61 [0.33, 0.88] Psychological well-being 2.03 0.32 [0.86, 2.56] 3.96 < .001 0.50 [0.23,0.78] Situational Self-Awareness Scale (SSAS) SSAS total 4.63 -0.13 [3.06, 6.45] 5.52 < .001 0.71 [0.43, 0.99] Note . Δ was computed as post − pre (post-intervention minus baseline). Positive Δ indicates an increase; negative Δ indicates a decrease. Between-group statistics compare change scores (Retreat − Control) using two-tailed Welch’s t-tests; 95% CIs refer to the between-group mean difference in Δ. Cohen’s d was computed with the pooled SD and is coded as Retreat − Control (sign follows the same direction). For interpretation, increases indicate improvement for SCS positive (self-kindness, common humanity, mindfulness), MHC-SF subscales, and SSAS; decreases indicate improvement for DASS-21 subscales and SCS negative (self-judgment, isolation, over-identification). Sample sizes: n = 120 (Retreat) and n = 92 Control). Table 3 summarizes the comparison of pre–post change scores (Δ = post − pre) between the Retreat and Control groups across all outcomes. For the SCS-SF, the Retreat group showed significantly greater improvements than the Control group. Specifically, in self-kindness the Retreat group exhibited a significantly larger increase (Δ = 0.87) than controls (Δ = 0.26), with a moderate effect size (d = 0.43, 95% CI [0.16, 0.71]; p = .001). Common humanity and mindfulness also increased significantly more in the Retreat group (Δ = 0.97 and 0.56, respectively; both p < .001), with effect sizes in the small-to-moderate range (d = 0.72 and 0.49, respectively). Self-judgment, isolation, and over-identification showed larger reductions in the Retreat group than in controls (all p ≤ .01), with small-to-moderate effects (d = 0.34–0.61). For the SCS composite scores, the Retreat group achieved greater increases in positive self-compassion (SCS-Positive: Δ = 2.39, d = 0.73, p < .001) and greater reductions in negative self-compassion (SCS-Negative: Δ = −3.27, d = − 0.66, p < .001). For the DASS-21, the Retreat group showed a significantly larger reduction in depression (Δ = −3.15) than controls (Δ = −0.33; d = − 0.55, p < .001). While both groups improved on anxiety, the between-group difference did not reach significance (p = .102), though the trend favored the Retreat group (Δ = −2.25 vs − 1.00). For stress, the Retreat group exhibited a marked reduction (Δ = −6.78 vs − 0.80; d = − 0.92, p < .001). Regarding the MHC-SF, the Retreat group reported significantly greater increases in emotional well-being (Δ = 0.76 vs 0.18; d = 0.33, p = .012), social well-being (Δ = 2.04 vs 0.16; d = 0.61, p < .001), and psychological well-being (Δ = 2.03 vs 0.32; d = 0.50, p < .001). On the SSAS, the Retreat group demonstrated a substantial increase (Δ = 4.63), whereas the Control group showed no meaningful change (Δ = −0.13). The between-group difference was significant (d = 0.71, p < .001). Overall, the largest effects were observed for self-compassion, stress reduction, and well-being, underscoring the clinical relevance of the retreat intervention. Table 4 Adjusted Group Differences at Post-Test: ANCOVA Results for Outcomes with Baseline Differences Outcome Group Effect (β [SE]) t p Partial η² [95% CI] Depression (DASS-21) 3.93 (0.60) 6.57 < .001 0.17 [0.10, 1.00] Self-kindness (SCS) -0.87 (0.17) -5.17 < .001 0.11 [0.05, 1.00] Isolation (SCS) 1.15 (0.19) 6.07 < .001 0.15 [0.08, 1.00] Emotional Well-being (MHC-SF) -1.14 (0.26) -4.39 < .001 0.10 [0.08, 1.00] Social Well-being (MHC-SF) -2.83 (0.44) -6.49 < .001 0.17 [0.10, 1.00] Psychological Well-being (MHC-SF) -2.78 (0.47) -5.93 < .001 0.14 [0.08, 1.00] Situational Self-Awareness (SSAS) -2.94 (0.83) -3.54 .001 0.06 [0.02, 1.00] Note. Models : post ~ pre + group . The group effect (β) is coded as Control − Retreat at post-test, controlling for baseline. Thus, for symptom scales (DASS-21), β > 0 implies lower adjusted symptoms in the retreat group; for favorable constructs (SCS positive, MHC-SF, SSAS), β < 0 implies higher adjusted scores in the retreat group. Table 4 presents the adjusted group differences at post-test for all outcomes that showed baseline differences, as estimated by ANCOVA models controlling baseline scores. After adjustment, the Retreat group showed lower adjusted post-test DASS-21 than the Control group (β = 3.93, SE = 0.60, t = 6.57, p < .001; partial η² = 0.17, 95% CI [0.10, 1.00]). SCS was higher in the Retreat group at post-test (β = −0.87, SE = 0.17, t = − 5.17, p < .001; partial η² = 0.11), and Isolation (SCS) was lower (β = 1.15, SE = 0.19, t = 6.07, p < .001; partial η² = 0.15). Across the MHC-SF domains, the Retreat group showed higher adjusted post-test scores in Emotional (β = −1.14, SE = 0.26, t = − 4.39, p < .001; partial η² = 0.08), Social (β = −2.83, SE = 0.44, t = − 6.49, p < .001; partial η² = 0.17), and Psychological well-being (β = −2.78, SE = 0.47, t = − 5.93, p < .001; partial η² = 0.14). For Situational Self-Awareness (SSAS), the Retreat group also showed higher adjusted post-test scores (β = −2.94, SE = 0.83, t = − 3.54, p = .001; partial η² = 0.06). Using conventional benchmarks (η² ≈ .01 small, .06 medium, .14 large) (Richardson, 2011 ), effects ranged from medium to large, supporting the robustness of the intervention effects. Discussion The main objective of the present study was to evaluate the effects of a 5-day Zen retreat, as proposed by Marsha Linehan, on health professionals with previous training in DBT. This group was compared to a control group of health professionals, also trained in DBT, who attended psychoeducational dharma talks without meditation practice during the same period. The balance between change and acceptance is central in DBT (Linehan, 1993b ). While the goal of behaviour therapy is change the goal of Zen is simply mindful practice (Wolbert, 2017 ). Even changes in the primary objective (i.e. symptom) are not intended, mindfulness could be understood as a transformation of the relationship between self and symptom (Sauer et al. 2011 ). There is limited research exploring the effects of interventions in a retreat format within the mindfulness field, and none have been specifically designed around the Zen-derived principles of DBT, although Zen Buddhist philosophy is central to this contextual therapy. Additionally, the study gave us insight on this never studied DBT training component for health care workers already trained on DBT. Intensive mindfulness practice is thought to decrease suffering, increase happiness, enhance mental control, and foster the ability to experience reality as it is, without delusion (Wolbert, 2017 ). When comparing the 5-day Zen retreat to our control condition on clinical indexes, the retreat group showed a significantly greater reduction in psychological distress. This is consistent with meta-analytic data that has shown that MBIs reduce psychological distress in non-clinical adults (Galante et al., 2021 ). Depression scores were significantly reduced following the retreat. The effects of mindfulness practices on improving mood and affect are well-documented (Hofmann et al., 2010 ) and have been supported in subsequent metanalysis (Sommers-Spijkerman et al. 2021 ). This was the case for depression and for stress, which showed moderate and large effect sizes, respectively. As depression research, several meta-analyses focusing on stress have reported benefits associated with MBIs (Grossman et al., 2004 ; Pascoe et al, 2017 ). We wish to underscore the clinical relevance of reducing stress healthcare professionals, who are at high risk of suffering from it and experiencing burnout (e.g., Weinberg & Creed, 2000 ). Findings from a meta-analysis have warned that healthcare providers dealing with suicidal behaviours, such is the case of DBT therapist, report high emotional exhaustion (O’Connor 2018) and have shown that the burnout level of the therapists were associated with an increased likelihood of unsafe self-care, unprofessional behaviors, and low patient satisfaction (Salyers et al. 2017 ). In the current study, with approximately one hundred individuals per arm, the Zen retreat condition yielded a large effect size improving quality of live among Health care workers in retreat condition. This is interesting since quality of current evidence in these population and mindfulness is less frequent and the data has been limited by small sample sizes studies (Burton et al., 2017 ). Contrary to our expectations, we did not find equally pronounced decreases in anxiety when the two conditions were compared, although the trend favoured the retreat group. This result contrasts with some meta-analyses reporting moderate effects of meditation retreats on anxiety (Khoury et al. 2017 ). However, Sommers-Spijkerman et al. ( 2021 ) metanalysis reported that while effects on depression and stress were moderate and statistically significant, the effect on anxiety was smaller. Overall, the improvements in affect, the reduction in stress, and the decreases in feelings of self-judgment and isolation suggest beneficial on clinical domines stemming from the meditation and silence condition compared to control condition without meditation but dharma talk. In our study, the data indicated higher levels of self-kindness, common humanity, and mindfulness, as well as improvements in all three assessed domains of mental health (i.e., emotional, social, and psychological). It is interesting to note the increase in self-compassion scores, as compassion-focused meditation is not an explicit component of a Zen retreat. Increases in self-compassion resulting from purely contemplative practices have been previously reported (Birnie et al., 2010 ; Brito-Pons et al. 2018 ; Kuyken et al., 2010 ). In contrast to compassion training such as Mindful Self-Compassion (Neff & Germer, 2013 ) or Compassionate Mind Training (Gilbert & Procter, 2006 ) in MBIs or Zen retreat is often implicitly integrated as a foundational attitude in the instructors' interactions with participants (Kabat-Zinn, 1990 ; Kuyken et al., 2010 ). Although it is widely acknowledged as a key attitudinal element of mindfulness practice, it is typically not directly instructed. Instead, instructors model a compassionate approach that participants can adopt in relating to their own experiences. In longer retreats, increases in cooperativeness (i.e. a sense of being helpful), compassionate feelings, and empathy have been reported, along with increases in positive and balanced affect (Montero-Marin et al. 2016 ; Rosenberg et al., 2015 ). In shortened retreats, such as the present one, increased self-compassion has also been reported (Djernis et al. 2021 ). This curiously happens even when restricted verbal or other social interactions were limited. In our study, high scores in social well-being indicate positive social functioning, a healthy relationship with one's community and society, and the belief that one has something important to offer the world. It also encompasses a sense of belonging, feeling supported by a community, acceptance of others, and the potential for societal growth (Keyes et al., 2008 ). Acceptance, is a core element in DBT and in the retreat, refers to freedom from desiring that things should be different from what they are, and it is a necessary skill to acquire in the pursuit of joy. Is the willingness to experience life as it is, not how we want it to be. This not only should transform suffering also may leads to increase capacity for joy (Linehan,1993b). According to Linehan, this involves moving beyond knowing, and experiencing connection to the universe, towards essential goodness, and essential validity. Accessing to this joy is the final stage in (i.e. the fourth) DBT progression. The first two stages in DBT are clinically focused (i.e., behavioural control and emotional reprocessing), while the third and fourth are more related to positive affect (i.e., normal happiness and a sustained capacity for joy (Casellas et al., 2024). We were also interested in assessing positive affect and well-being variables. A metanalysis (Galante et al., 2021 ) and systematic review (Van Agteren et al. 2021 ) found that MBIs not only significantly improve mental illness but also enhance well-being across a variety of samples. However, studies in non-clinical populations often exhibit greater heterogeneity and a higher risk of bias. This field of research requires further standardization of protocols, evaluation of cost-effectiveness, and expansion of access to maximize its potential as a preventive health tool (Van Agteren et al. 2021 ). Self-selection bias on retreat studies limits the generalizability of results, as retreat-goers often have higher initial motivation. Additional limitations include accessibility since many retreats are costly and time-consuming, limiting participation to privileged groups. Addressing these methodological, socioeconomic, and research gaps is essential for integrating retreats as accessible, effective tools in preventive healthcare (Giridharan, 2024 ). Beyond the social facet, the Zen retreat appears to promote other positive-oriented outcomes, such as psychological well-being and all positive polarities of self-compassion (i.e., common humanity, mindfulness, self-kindness), as well as situational self-awareness of both environmental and private experiences. Our findings indicate that the intensive practice of mindfulness is associated with positive changes in the four measures used in this study and in 12 out of 14 of their subscales. Although some studies on retreats have reported occasional negative outcomes associated with retreat participation (Baer et al., 2019 ; Lindahl et al., 2017 ; Sedlmeier, 2018), in the current study, the impact on participants has been salutary. Finally, it is important to highlight the relevance of the Zen mindfulness retreat for health professionals trained in DBT. This training component, which had not been previously evaluated, showed beneficial effects on clinical, quality of live and well-being domines. A future direction for research would be to determine whether this component of DBT training also enhances practitioners' efficiency in delivering the therapy, particularly in teaching mindfulness and acceptance skills to patients, and whether promotes or not later DBT model adoption (Navarro-Haro et al. 2019 ) . Declarations Funding: No funds, grants or other support was received. The authors have no conflicts of interest to declare that are relevant to the content of this article. Author Contribution **KS:** recruited the study sample and contributed to writing the original draft and to review and editing. **MAM:** designed the study protocol and contributed to writing the original draft and to review and editing. **MA:** performed the formal analyses (applying statistical, mathematical, and other formal techniques to analyze and synthesize the data), curated the dataset, and contributed to writing the original draft and to review and editing. **RW:** delivered the intervention to the experimental group and contributed to writing the original draft and to review and editing. **JG:** contributed to writing the original draft and to review and editing. **VF:** recruited the study sample and contributed to writing the original draft and to review and editing. **JS:** designed the study protocol, supervised the study, and contributed to writing the original draft and to review and editing. Acknowledgement We would like to express our sincere gratitude to Geraldine Rodríguez for providing the resources that made it possible to recruit participants for the control group. Her contribution was essential to the completion of this study. Data Availability Data cannot be shared openly to protect study participant privacy. References Baer, R., Crane, C., Miller, E., & Kuyken, W. (2019). Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings. Clinical psychology review , 71 , 101–114. https://doi.org/10.1016/j.cpr.2019.01.001 Birnie, K., Speca, M., & Carlson, L. (2010). Exploring self-compassion and empathy in the context of mindfulness-based stress reduction (MBSR). Stress and Health, 26 (5), 359–371. https://doi.org/10.1002/smi.1305. Bohus, M., Stoffers-Winterling, J., Sharp, C., Krause-Utz, A., Schmahl, C., & Lieb, K. (2021). Borderline personality disorder. Lancet (London, England) , 398 (10310), 1528–1540. https://doi.org/10.1016/S0140-6736(21)00476-1 Brito-Pons, G., Campos, D., & Cebolla, A. (2018). Implicit or explicit compassion? Effects of compassion cultivation training and comparison with mindfulness-based stress reduction. Mindfulness, 9 (5), 1494–1508. https://doi.org/10.1007/s12671-018-0898-z. Burton, A., Burgess, C., Dean, S., Koutsopoulou, G. Z., & Hugh-Jones, S. (2017). How Effective are Mindfulness-Based Interventions for Reducing Stress Among Healthcare Professionals? A Systematic Review and Meta-Analysis. Stress and health : journal of the International Society for the Investigation of Stress , 33 (1), 3–13. https://doi.org/10.1002/smi.2673 Carmona i Farrés, C., Elices, M., Soler, J., Domínguez-Clavé, E., Pomarol-Clotet, E., Salvador, R., & Pascual, J. C. (2019). Effects of mindfulness training on borderline personality disorder: Impulsivity versus emotional dysregulation. Mindfulness, 10 (7), 1243–1254. https://doi.org/10.1007/s12671-018-1071-4 Casellas-Pujol, E., Soler, J., Schmidt, C., Soria-Madrid, A., Elices, M., & Pascual, J. C. (2024). Contextual-compassion training for borderline personality disorder with long lasting symptoms: A randomized clinical trial. Journal of Contextual Behavioral Science , 34 , 100846. Cocker, F., & Joss, N. (2016). Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review. International journal of environmental research and public health, 13 (6), 618. https://doi.org/10.3390/ijerph13060618. Djernis, D., O'Toole, M. S., Fjorback, L. O., Svenningsen, H., Mehlsen, M. Y., Stigsdotter, U. K., & Dahlgaard, J. (2021). A Short Mindfulness Retreat for Students to Reduce Stress and Promote Self-Compassion: Pilot Randomised Controlled Trial Exploring Both an Indoor and a Natural Outdoor Retreat Setting. Healthcare (Basel, Switzerland) , 9 (7), 910. https://doi.org/10.3390/healthcare9070910 Eeles, J., & Walker, D. M. (2022). Mindfulness as taught in Dialectical Behaviour Therapy: A scoping review. Clinical psychology & psychotherapy , 29 (6), 1843–1853. https://doi.org/10.1002/cpp.2764 Elices, M., Pascual, J. C., Portella, M. J., Feliu-Soler, A., Martín-Blanco, A., Carmona, C., & Soler, J. (2016). Impact of mindfulness training on borderline personality disorder: A randomized trial. Mindfulness, 7 (3), 584–595. https://doi.org/10.1007/s12671-016-0492-1 Galante, J., Friedrich, C., Dawson, A. F., Modrego-Alarcón, M., Gebbing, P., Delgado-Suárez, I., Gupta, R., Dean, L., Dalgleish, T., White, I. R., & Jones, P. B. (2021). Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials. PLoS medicine , 18 (1), e1003481. https://doi.org/10.1371/journal.pmed.1003481 Gilbert, P., & Procter, S. (2006). Compassionate Mind Training for People with High Shame and Self-Criticism: Overview and Pilot Study of a Group Therapy Approach. Clinical Psychology & Psychotherapy, 13 (6), 353–379. https://doi.org/10.1002/cpp.507. Giridharan S. (2024). Residential Meditation Retreats: A Promise of Sustainable Well-Being?. Cureus , 16 (11), e73326. https://doi.org/10.7759/cureus.73326. Govern, J. M. & Marsch L. A. (2001). Development and validation of situational self-awareness scale. Consciousness and Cognition , 10 (3), 366-378. Greenberg, L. S., Elliott, R., Watson, J. C., & Bohart, A. C. (2001). Empathy. Psychotherapy: Theory, Research, Practice, Training , 38 (4), 380–384. https://doi.org/10.1037/0033-3204.38.4.380 Grepmair, L., Mitterlehner, F., Loew, T., & Nickel, M. (2007). Promotion of mindfulness in psychotherapists in training: Preliminary study. European Psychiatry , 22 (8), 485-489. Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits. A meta-analysis. Journal of psychosomatic research , 57 (1), 35–43. https://doi.org/10.1016/S0022-3999(03)00573-7 Henry, J. D., & Crawford, J. R. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44 (2), 227–239. https://doi.org/10.1348/014466505X29657. Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of consulting and clinical psychology , 78 (2), 169–183. https://doi.org/10.1037/a0018555 Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness . Delta. Keyes, C. L. M. (2002). The Mental Health Continuum: From Languishing to Flourishing in Life. Journal of Health and Social Behavior , 43 (2), 207-222. https://doi.org/10.2307/3090197 Keyes, C. L., Wissing, M., Potgieter, J. P., Temane, M., Kruger, A., & van Rooy, S. (2008). Evaluation of the mental health continuum-short form (MHC-SF) in setswana-speaking South Africans. Clinical psychology & psychotherapy , 15 (3), 181–192. https://doi.org/10.1002/cpp.572. Khoury, B., Knäuper, B., Schlosser, M., Carrière, K., & Chiesa, A. (2017). Effectiveness of traditional meditation retreats: A systematic review and meta-analysis. Journal of psychosomatic research , 92 , 16–25. https://doi.org/10.1016/j.jpsychores.2016.11.006 Kuyken, W., Watkins, E., Holden, E., White, K., Taylor, R. S., Byford, S., Evans, A., Radford, S., Teasdale, J. D., & Dalgleish, T. (2010). How does mindfulness-based cognitive therapy work?. Behaviour research and therapy , 48 (11), 1105–1112. https://doi.org/10.1016/j.brat.2010.08.003 Lambert, M. J., & Barley, D. E. (2002). Research summary on the therapeutic relationship and psychotherapy outcome. In J. C. Norcross (Ed.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (17–32). Oxford University Press. Lamers, S. M., Westerhof, G. J., Bohlmeijer, E. T., ten Klooster, P. M., & Keyes, C. L. (2011). Evaluating the psychometric properties of the Mental Health Continuum-Short Form (MHC-SF). Journal of clinical psychology , 67 (1), 99–110. https://doi.org/10.1002/jclp.20741 Lau, M. A., & McMain, S. F. (2005). Integrating mindfulness meditation with cognitive and behavioural therapies: The challenge of combining acceptance-and change-based strategies. The Canadian Journal of Psychiatry , 50 (13), 863-869. Lindahl, J. R., Fisher, N. E., Cooper, D. J., Rosen, R. K., & Britton, W. B. (2017). The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists. PloS one , 12 (5), e0176239. https://doi.org/10.1371/journal.pone.0176239 Linehan, M. M. (1993a). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press. Linehan, M. M. (1993b). Skills training manual for treating borderline personality disorder. Guilford Press. Linehan, M. M. (2014). DBT skills training manual (2nd ed.). Guilford Press. Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour research and therapy , 33 (3), 335–343. https://doi.org/10.1016/0005-7967(94)00075-u Montero-Marin, J., Puebla-Guedea, M., Herrera-Mercadal, P., Cebolla, A., Soler, J., Demarzo, M., Vazquez, C., Rodríguez-Bornaetxea, F., & García-Campayo, J. (2016). Psychological Effects of a 1-Month Meditation Retreat on Experienced Meditators: The Role of Non-attachment. Frontiers in psychology , 7 , 1935. https://doi.org/10.3389/fpsyg.2016.01935 Navarro-Haro, M. V., Harned, M. S., Korslund, K. E., DuBose, A., Chen, T., Ivanoff, A., & Linehan, M. M. (2019). Predictors of Adoption and Reach Following Dialectical Behavior Therapy Intensive Training™. Community mental health journal , 55 (1), 100–111. https://doi.org/10.1007/s10597-018-0254-8 Neff, K. D. (2003). Development and validation of a scale to measure self-compassion. Self and Identity , 2, 223-250. Neff, K. D., & Germer, C. K. (2013). A pilot study and randomized controlled trial of the mindful self-compassion program. Journal of clinical psychology , 69 (1), 28–44. https://doi.org/10.1002/jclp.21923 Nutting, R., Ofei-Dodoo, S., Rose-Borcherding, K., & Strella, G. (2022). Brief Mindfulness Intervention for Emotional Distress, Resilience, and Compassion in Family Physicians During COVID-19: A Pilot Study. PRiMER (Leawood, Kan.) , 6 , 3. https://doi.org/10.22454/PRiMER.2022.746202 O'Connor, K., Muller Neff, D., & Pitman, S. (2018). Burnout in mental health professionals: A systematic review and meta-analysis of prevalence and determinants. European psychiatry : the journal of the Association of European Psychiatrists , 53 , 74–99. https://doi.org/10.1016/j.eurpsy.2018.06.003 Pascoe, M. C., Thompson, D. R., Jenkins, Z. M., & Ski, C. F. (2017). Mindfulness mediates the physiological markers of stress: Systematic review and meta-analysis. Journal of psychiatric research , 95, 156–178. https://doi.org/10.1016/j.jpsychires.2017.08.004. Raes, F., Pommier, E., Neff, K. D., & Van Gucht, D. (2011). Construction and factorial validation of a short form of the Self-Compassion Scale. Clinical psychology & psychotherapy , 18 (3), 250–255. https://doi.org/10.1002/cpp.702 Razzaque, R., & Wood, L. (2016). Exploration of the effectiveness and acceptability of a professional mindfulness retreat for psychiatrists. Mindfulness, 7 (2), 340–348. https://doi.org/10.1007/s12671-015-0443-2 Richardson, J. T. E. (2011). Eta squared and partial eta squared as measures of effect size in educational research. Educational Research Review, 6 (2), 135–147. Robins, C. J. (2002). Zen principles and mindfulness practice in dialectical behavior therapy. Cognitive and behavioral practice , 9 (1), 50-57. Rosenberg, E. L., Zanesco, A. P., King, B. G., Aichele, S. R., Jacobs, T. L., Bridwell, D. A., MacLean, K. A., Shaver, P. R., Ferrer, E., Sahdra, B. K., Lavy, S., Wallace, B. A., & Saron, C. D. (2015). Intensive meditation training influences emotional responses to suffering. Emotion, 15 (6), 775–790. https://doi.org/10.1037/emo0000080 Salyers, M. P., Bonfils, K. A., Luther, L., Firmin, R. L., White, D. A., Adams, E. L., & Rollins, A. L. (2017). The Relationship Between Professional Burnout and Quality and Safety in Healthcare: A Meta-Analysis. Journal of general internal medicine , 32 (4), 475–482. https://doi.org/10.1007/s11606-016-3886-9 Sauer, S., Lynch, S., Walach, H., & Kohls, N. (2011). Dialectics of mindfulness: implications for western medicine. Philosophy, ethics, and humanities in medicine : PEHM , 6 , 10. https://doi.org/10.1186/1747-5341-6-10 Schmidt, C., Soler, J., Carmona I Farrés, C., Elices, M., Domínguez-Clavé, E., Vega, D., & Pascual, J. C. (2021). Mindfulness in Borderline Personality Disorder: Decentering Mediates the Effectiveness. Psicothema , 33 (3), 407–414. https://doi.org/10.7334/psicothema2020.437 Sedlmeier, P., Loße, C., & Quasten, L. C. (2018). Psychological effects of meditation for healthy practitioners: an update. Mindfulness , 9 (2), 371-387. Shapiro, S. L., Carlson, L. E., Astin, J. A., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of clinical psychology , 62 (3), 373–386. https://doi.org/10.1002/jclp.20237 Soler, J., Elices, M., Pascual, J. C., Martín-Blanco, A., Feliu-Soler, A., Carmona, C., & Portella, M. J. (2016). Effects of mindfulness training on different components of impulsivity in borderline personality disorder: results from a pilot randomized study. Borderline personality disorder and emotion dysregulation , 3 , 1. https://doi.org/10.1186/s40479-015-0035-8 Soler, J., Arqueros, M., Schmidt, C., Otero, D., Soria-Madrid, A., Campins, M. J., Catalan, A., Casellas, E., Espeso, R., & Pascual, J. C. (2025). Scale to measure dialectical thinking from Dialectical Behavior Therapy perspective. European Journal of Psychiatry, 39 (2). https://doi.org/10.1016/j.ejpsy.2025.100305 Sommers-Spijkerman, M., Austin, J., Bohlmeijer, E., & Pots, W. (2021). New Evidence in the Booming Field of Online Mindfulness: An Updated Meta-analysis of Randomized Controlled Trials. JMIR mental health , 8 (7), e28168. https://doi.org/10.2196/28168 Van Agteren, J., Iasiello, M., Lo, L., Bartholomaeus, J., Kopsaftis, Z., Carey, M., & Kyrios, M. (2021). A systematic review and meta-analysis of psychological interventions to improve mental wellbeing. Nature human behaviour , 5 (5), 631-652. Weinberg, A., & Creed, F. (2000). Stress and psychiatric disorder in healthcare professionals and hospital staff. Lancet (London, England) , 355 (9203), 533–537. https://doi.org/10.1016/S0140-6736(99)07366-3 Wolbert, R. (2017). Modifying behaviour therapy to meet the challenge of treating borderline personality disorder: Incorporating Zen and mindfulness . En M. A. Swales (Ed.), The Oxford handbook of dialectical behaviour therapy . Oxford University Press. https://doi.org/10.1093/oxfordhb/9780198758723.013.5 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7750231","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":534626089,"identity":"be79e0f5-e5c5-43b6-aaa3-983cf95e467b","order_by":0,"name":"Karina Solovieff","email":"","orcid":"","institution":"Universidad de Palermo","correspondingAuthor":false,"prefix":"","firstName":"Karina","middleName":"","lastName":"Solovieff","suffix":""},{"id":534626090,"identity":"ae060e37-ac5c-49cc-b29d-2feeee06bb1c","order_by":1,"name":"Miguel Angel Murua","email":"","orcid":"","institution":"Universidad de Buenos Aires","correspondingAuthor":false,"prefix":"","firstName":"Miguel","middleName":"Angel","lastName":"Murua","suffix":""},{"id":534626091,"identity":"406b33f0-b932-44f3-a0bb-a6584a5536d8","order_by":2,"name":"Maria Arqueros","email":"","orcid":"","institution":"Autonomous University of Barcelona","correspondingAuthor":false,"prefix":"","firstName":"Maria","middleName":"","lastName":"Arqueros","suffix":""},{"id":534626092,"identity":"dd7177ff-f098-4ff2-909e-a23ffa16fdf6","order_by":3,"name":"Randy Wolbert","email":"","orcid":"","institution":"Empty Cloud Sangha, Inc","correspondingAuthor":false,"prefix":"","firstName":"Randy","middleName":"","lastName":"Wolbert","suffix":""},{"id":534626093,"identity":"42dc712a-5bfb-412e-ace0-48e691c96623","order_by":4,"name":"Jan Glasenapp","email":"","orcid":"","institution":"Nanjing Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jan","middleName":"","lastName":"Glasenapp","suffix":""},{"id":534626094,"identity":"c6e42948-8cbd-4c93-88d2-8098c956f403","order_by":5,"name":"Vibh Forsythe","email":"","orcid":"","institution":"University of Washington","correspondingAuthor":false,"prefix":"","firstName":"Vibh","middleName":"","lastName":"Forsythe","suffix":""},{"id":534626095,"identity":"cada1da9-1446-49bd-b2eb-809c28f41ecc","order_by":6,"name":"Joaquim Soler","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6klEQVRIie3PMWvCQBTA8RcEszwMbidtv0MkoFv9KgmFTFm6FIqDNzkJt+ZjOIlDh3c8MEvENWOgkK7NUhyK9JS6OBwZHe6/veP9eByAy3WH+Yo8Ajhh0Jl4eQyGMI6kmej/UdrJZZEhpO6kR9R+8GN04Oaz3T4n0uev2krULtZ5c8JJlU5DXb4kEtOx/YrMQkY6GgIToZe9RAroQH6pxEgVP4YsDPFbKxmeCdAOQ8jOV9gQtF95EGmsV8QoquxN7MsiWmL2mtvIIGBdH4lngSo24n07f1J+sf62kdufAfS7r1+Jy+VyuW77A1KsV0AYy0UwAAAAAElFTkSuQmCC","orcid":"","institution":"Hospital de Sant Pau","correspondingAuthor":true,"prefix":"","firstName":"Joaquim","middleName":"","lastName":"Soler","suffix":""}],"badges":[],"createdAt":"2025-09-30 10:08:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7750231/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7750231/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":94588683,"identity":"e18ac4ea-4395-45c1-bb7f-e62009953486","added_by":"auto","created_at":"2025-10-28 18:19:41","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":87472,"visible":true,"origin":"","legend":"","description":"","filename":"TheeffectsofDBTzenretreatonHCp300925MQ.docx","url":"https://assets-eu.researchsquare.com/files/rs-7750231/v1/8bd0cccd30b1dd861efb726f.docx"},{"id":94589841,"identity":"37508bc1-e0da-4954-b68b-34c354eab64a","added_by":"auto","created_at":"2025-10-28 18:20:40","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":9046,"visible":true,"origin":"","legend":"","description":"","filename":"a8e51b07e37f46c5bf53bf499fd70d1d.json","url":"https://assets-eu.researchsquare.com/files/rs-7750231/v1/3bb008eb824ff954dc5e0c61.json"},{"id":94588891,"identity":"aa7f5fff-d70f-4f5e-a345-def64874630a","added_by":"auto","created_at":"2025-10-28 18:19:52","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":192888,"visible":true,"origin":"","legend":"","description":"","filename":"a8e51b07e37f46c5bf53bf499fd70d1d1enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7750231/v1/df66c0d56b4dbeecb1e6d659.xml"},{"id":94589726,"identity":"0c72efbb-e6dc-48a5-a0b1-b9a7b450fd03","added_by":"auto","created_at":"2025-10-28 18:20:36","extension":"xml","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":188626,"visible":true,"origin":"","legend":"","description":"","filename":"a8e51b07e37f46c5bf53bf499fd70d1d1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7750231/v1/2d13a58c7c7486ab1cd61dc7.xml"},{"id":94589721,"identity":"0149e5be-4217-42f2-a387-60ad64961751","added_by":"auto","created_at":"2025-10-28 18:20:36","extension":"html","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":200436,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7750231/v1/626e4e043147e02c34dfae56.html"},{"id":94597023,"identity":"b2626b13-1aa2-4806-8458-722e37b5fba0","added_by":"auto","created_at":"2025-10-28 18:45:22","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1326681,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7750231/v1/c6c99d4a-9da0-4ccf-9c71-95cda565991e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Effects of Dialectical Behaviour Therapy Zen retreat on healthcare workers","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDialectical Behaviour Therapy (DBT) evolved as a synthesis of three paradigms: behaviourism, mindfulness and dialectics, synthesizing of cognitive-behavioural principles and Buddhist philosophy (Linehan, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e1993a\u003c/span\u003e) for treating Borderline Personality Disorder (BPD), currently DBT is the more empirically supported therapy for the most common specific Personality Disorder (Bohus et al. \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). There is a direct connection in between the Mindfulness skills and Zen background, and this is probably the most recognizable part of the merge of both in this contextual therapy. But along with mindfulness, Radical Acceptance and Dialectics are also Zen based. Radical Acceptance encourages non-attachment to experience and see that \"\u003cem\u003ethe essential world of perfection is this very world\u003c/em\u003e\" (Wolbert, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) and Dialectics includes features such transcending dualistic thinking (e.g., subject-object distinctions) and promotes interconnection, transaction and the impermanence of any given experience (Soler et al. \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThere is another facet even more intimately connected to Zen and frequently dismissed, the retreat. Meditation retreats (sesshins in the Zen tradition) are periods of intensive practice that take place in an environment of isolation from the influences of the world and during a break from usual activities, usually in a group format and guided by a teacher who transmits the Dharma teachings to the participants. It is a fundamental practice for those who have decided to deepen their meditation practice beyond the daily sessions for a relatively limited time. The author of the therapy, who also is a Zen master (Roshi), establish a five-day residential mindfulness retreat including daily formal and informal practices and rest periods. The program combines daily seated meditation, mindful walking practice, daily mindfulness talks (dharma talk) while participants maintain \"noble silence\" throughout the day.\u003c/p\u003e\u003cp\u003eTo incorporate mindfulness, acceptance and dialectics, beyond intellectual understanding, and being capable of effectively teaching those skills, having a personal mindfulness practice is stressed by Marsha Linehan. Indeed, she pointed attending to mindfulness Zen retreats to effectively get this goal (Linehan, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Mindfulness is thought to be essential for DBT therapists, helps to flexibly balance acceptance and change, avoid distractions, cognitive distortions, and rigid rule adherence that hinder dialectical practice (Robins et al., 2002). Zen would help therapists maintain treatment focus in the case of highly complex patients, such as people with BPD, by noticing and contextualizing behaviours without judgment, better regulating therapist\u0026rsquo;s emotions in ongoing session, promote detachment from outcomes while keeping patient's goals in mind, fostering recognition and acceptance of personal and patient limitations, patient's inherent capabilities and phenomenological empathy (Lau \u0026amp; McMain \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2005\u003c/span\u003e; Wolbert \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAlthough mindfulness and the acceptance component of DBT has been previously object of study and were already associated with increases non-judgemental stand, attention, emotional regulation and decentring and decreases BPD symptoms and impulsivity (Eeles et al. 2022; Elices et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Carmona i Farr\u0026eacute;s et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Schmidt et al. \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Soler et al. \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Although, research in dialectic component and Zen retreat in DBT is scarce (Sauer et al. \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Soler et al., \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). In the case of the last, there is only one no controlled study from Razzaque \u0026amp; Wood (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), testing a short Zen oriented retreat on 22 consultant psychiatrists. The retreat lasted 2 days and significantly reduced burnout and improved therapeutic alliance among psychiatrists. However, shortness, small sample size, and the absence of a control condition limit the generalizability of, these otherwise, promising results. The current study aims to respond unanswered questions about the unique contributions of this teaching component on therapeutic outcomes in DBT trained professionals working in a health care area.\u003c/p\u003e\u003cp\u003eHealthcare workers are disproportionately affected by burnout, anxiety and compassion fatigue (Cocker \u0026amp; Joss \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). The emotional demands of patient care, coupled with systemic pressures such as workload and bureaucratic constraints, have been pointed out to contribute to elevated rates of emotional distress across wide range of clinical settings (e.g., Weinberg, \u0026amp; Creed, \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2000\u003c/span\u003e). Workplace stress has been linked to considerable number of negative outcomes, including reduced psychological well-being, lower quality of care, and reduced patient\u0026rsquo;s satisfaction. Preliminary studies on mindfulness-based interventions (MBIs) for healthcare professionals report moderate reductions in stress and improvements in well-being (Nutting et al., \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Khoury et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Burton et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Retreats offer a unique environment for sustained practice, free from daily distractions, which may amplify mindfulness\u0026rsquo;s benefits by deepening self-awareness and emotional regulation. Retreats have shown to enhance attentional control, reduce rumination, and increase self-compassion in variety of samples (Khoury et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Shapiro et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2006\u003c/span\u003e, considers mindfulness training offers a method of systematic self-care that may prevent therapist burnout and compassion fatigue. The rationale is grounded in empirical evidence demonstrating the capacity of mindfulness to reduce stress, enhance well-being, and cultivate self-compassion and posit that compassion for others is based upon one's own self-compassion. Empathic resonance (i.e., warmth, understanding, compassion), being able to be present and attentive have been identified as essential therapist skills for attending to clients\u0026rsquo; needs to successfully conduct the treatment (Greenberg et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2001\u003c/span\u003e; Lambert \u0026amp; Barley, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2002\u003c/span\u003e). In randomized, controlled, double-blind study therapist intervention group was instructed in daily Zen meditation and practiced before the workday began showed that mindfulness meditation taught to therapists may have the potential to positively influence treatment outcomes in clients (Grepmair et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). An intensive mode of mindfulness training would have the potential to have similar or better effects in a shorter time compared to a MBIs program and stand to benefit from combine DBT\u0026rsquo;s pragmatic skills with Zen\u0026rsquo;s emphasis on self-compassion and interconnectedness.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eParticipants\u003c/h2\u003e\u003cp\u003eThe study included a non-probabilistic, convenience sample of 212 mental health professionals (79.1% female) aged 26 to 77 years (M = 47.45, SD = 12.40). Participants were allocated to either the experimental group (n = 120) or the control group (n = 92), who were drawn from a waitlist. According to inclusion criteria, eligible participants were U.S. citizens aged 26–80 who were mental health professionals (e.g., psychologists, psychiatrists/physicians in mental health, or clinical social workers), had prior DBT training, provided written informed consent, data were collected anonymously and agreed to retreat community guidelines, although participants were encouraged to read recommended materials. Exclusion criteria were ongoing psychoactive substance use, acute psychotic episode at enrollment, or active communicable illness at the time of the retreat. One participant had missing group assignment data and was excluded from group comparisons.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eExperimental Condition\u003c/strong\u003e\u003c/p\u003e\u003cp\u003ePeople allocated in this branch attended a five-day intensive mindfulness retreat (DBT-based). They will practice different formal and informal Mindfulness practices. Each day will have rest periods of approximately one and a half hours.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThroughout each of the days there will be four blocks of seated meditation practice (sunrise, pre-noon, early afternoon and sunset). Each of these blocks will be divided into 25-minute periods, with mindful walking practice (5–7 minutes) between each block. In addition to the short walks between the periods of sitting meditation practice, a daily 15-minute walk will be taken before the start of the activities and another 30-minute walk in the afternoon. Through these activities, discipline and radical acceptance will be worked on. In the transitions from one type of practice to the other, the passage from stillness to movement and vice versa.\u003c/p\u003e\u003cp\u003eEach day, at mid-morning, the facilitator will give a talk on Mindfulness and in the afternoon, there will be a question-and-answer period for one hour. With these only exceptions, absolute silence (noble silence) will be maintained from the beginning to the end of the intervention. It should be noted that each participant will have an individual interview with the facilitator in which he/she will explain his/her motivations and expectations. Those who wish to do so will have the possibility of coordinating other interviews. Throughout the retreat, participants were encouraged to observe sensations, emotions, and thoughts non-reactively and to repeatedly return their attention to the present moment.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eControl Group\u003c/strong\u003e\u003c/p\u003e\u003cp\u003ePeople allocated to this group were assessed for the same length of five-day period. Were instructed to listen to five Zen Dharma talks (one per day), offering the same psychoeducational component of the Experimental Condition but non meditation practices were required neither complaining with silence instruction, The psychoeducational talks were written and recorded by the intervention coordinator.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eMeasures\u003c/h3\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003eMental Health Continuum – Short Form (MHC–SF)\u003c/h2\u003e\u003cp\u003eThe MHC–SF (Keyes, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2002\u003c/span\u003e) is a 14-item self-report instrument that measures three domains of positive mental health: emotional well-being, social well-being, and psychological well-being. Items are rated on a 6-point Likert scale according to frequency experienced (from \"Never\" to \"Every day\"). Cronbach’s alpha in the present study was 0.94 for the total scale, and above 0.80 for each subscale. The scale has demonstrated robust construct validity, with confirmatory factor analyses supporting a three-factor structure (Keyes, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2002\u003c/span\u003e; Lamers et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). Convergent validity has been shown via significant correlations with subjective well-being and social functioning; discriminant validity analyses indicate that positive mental health and mental illness are distinct but related dimensions.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eDepression, Anxiety and Stress Scales – 21 item version (DASS-21)\u003c/h3\u003e\n\u003cp\u003eThe DASS-21 (Lovibond \u0026amp; Lovibond, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e1995\u003c/span\u003e) is a 21-item self-report questionnaire measuring depression, anxiety, and stress (7 items per subscale) over the past week. Items are rated on a 4-point Likert scale from 0 (“Did not apply to me at all”) to 3 (“Applied to me very much, or most of the time”). Subscale scores are summed and multiplied by two for comparability with the original 42-item version. In this study, Cronbach’s alpha for the total scale was 0.90; subscale reliabilities were α = .91 for depression, α = .80 for anxiety, and α = .84 for stress. Previous research has supported a three-factor structure (Henry \u0026amp; Crawford, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2005\u003c/span\u003e), and the DASS-21 is widely validated in Spanish populations.\u003c/p\u003e\n\u003ch3\u003eSituational Self-Awareness Scale (SSAS)\u003c/h3\u003e\n\u003cp\u003eThe SSAS (Govern \u0026amp; Marsh, 2001) consists of 9 items measuring three facets of situational self-awareness: public, private, and environmental. Items are scored on a 7-point Likert scale from 1 (“Strongly disagree”) to 7 (“Strongly agree”), with instructions to respond based on “how you feel at this exact moment.” In the present study, Cronbach’s alpha for the total scale was 0.84. Factor-analytic studies support a three-factor structure. Subscale reliabilities reported in the literature are α = .82 (Public), .70 (Private), and .72 (Environmental); temporal stability (test-retest) ranges from r = .58 to .78.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eSelf-Compassion Scale – Short Form (SCS–SF)\u003c/h2\u003e\u003cp\u003eThe SCS–SF (Raes et al., \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Neff, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2003\u003c/span\u003e) is a 12-item self-report measure that assesses six dimensions of self-compassion, with two items per dimension: self-kindness, common humanity, mindfulness (positive dimensions); and self-judgment, isolation, and over-identification (negative dimensions). Items are rated from 1 (“Almost never”) to 5 (“Almost always”). Cronbach’s alpha in this study was 0.87 for the total scale. Subscale alphas in this sample were .86 for positive subscales (self-kindness, common humanity, mindfulness) and .76 for negative subscales (self-judgment, isolation, over-identification). The SCS–SF demonstrates strong psychometric properties, with confirmatory factor analysis supporting the six-factor model, and high convergent validity with the full 26-item version (Raes et al., \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2011\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eProcedure\u003c/h3\u003e\n\u003cp\u003eThe study was conducted with mental health professionals who voluntarily participated in a five-day residential mindfulness retreat (intervention group) or were assigned to a control group. The mindfulness retreat, as previously described, consisted of five consecutive days of intensive formal and informal mindfulness practice. The control group comprised professionals that did not attend the retreat but listened to one pre-recorded Dharma talk per day (written and recorded by the intervention facilitator) during the same period. Both groups were instructed not to engage in additional mindfulness practices or interventions during the study period. No randomization was performed.\u003c/p\u003e\u003cp\u003eSelf-report measures were completed electronically by all participants immediately before (pre) and after (post) the intervention period. Participation was anonymous and voluntary. Adherence was monitored through daily attendance records in the retreat group and confirmation of audio completion in the control group. The protocol was reviewed and approved by the Empty Cloud Sangha Research Committee (approval letter dated September 2, 2019). All participants provided written informed consent before any study procedure. The consent forms described study purpose, pre–post assessments, the control-condition instructions (listening to one Dharma talk per day), potential risks and lack of direct benefit, confidentiality safeguards (coded IDs, separation of identifiers, secure storage, and destruction after three years), and the voluntary nature of participation with the right to withdraw at any time; responses were collected anonymously.\u003c/p\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003eData Analysis\u003c/h2\u003e\u003cp\u003eFirst, baseline differences between retreat and control groups were assessed. For continuous variables independent samples \u003cem\u003et\u003c/em\u003e-tests were used; for categorical variables, the chi-square test was applied. Variables showing significant baseline differences were identified for later adjustment.\u003c/p\u003e\u003cp\u003eTo evaluate within-group changes over time, paired samples \u003cem\u003et\u003c/em\u003e-tests were performed separately in the retreat and control groups for each outcome measure (pre- vs. post-intervention scores).\u003c/p\u003e\u003cp\u003eBetween-group differences in change scores (delta: post minus pre) were then compared using independent samples \u003cem\u003et\u003c/em\u003e-tests.\u003c/p\u003e\u003cp\u003eFor variables with significant baseline group differences, analysis of covariance (ANCOVA) was performed. In these models, post-intervention scores served as the dependent variable, group allocation (retreat vs. control) as the independent variable, and baseline scores as covariates.\u003c/p\u003e\u003cp\u003eEffect sizes (Cohen’s \u003cem\u003ed\u003c/em\u003e for \u003cem\u003et\u003c/em\u003e-tests, partial eta squared for ANCOVAs) were calculated for all primary outcomes. All statistical analyses were conducted using RStudio (R version 4.3.3).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eBaseline Characteristics of the Sample\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetreat Group (n = 120)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eControl Group (n = 92)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e48.88 (12.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45.71 (11.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.058\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e% Female\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e74% (89/120)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e91% (84/92)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.078\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSelf-Compassion Scale\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e─ Self-Kindness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7.33 (1.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6.64 (1.90)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.005**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e─ Common Humanity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7.41 (1.65)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7.24 (1.93)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.501\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e─ Mindfulness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7.98 (1.22)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7.78 (1.39)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.251\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e─ Self-Judgment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.19 (2.01)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.67 (2.10)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.091\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e─ Isolation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.12 (1.96)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.71 (2.23)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.041*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e─ Over-Identification\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.52 (2.05)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.82 (2.36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.320\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e─ Positive Subscale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22.72 (3.75)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21.70 (4.36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.060\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e─ Negative Subscale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15.82 (5.17)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17.20 (6.18)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.070\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDASS-21\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e─ Depression\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.30 (6.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8.42 (8.38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.002**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e─ Anxiety\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7.02 (6.56)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6.67 (7.72)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.722\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e─ Stress\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13.05 (7.13)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14.93 (8.60)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.084\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMHC-SF\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e─ Emotional Well-being\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14.04 (2.74)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11.13 (2.85)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt; 0.001**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e─ Social Well-being\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18.77 (4.95)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14.58 (4.60)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt; 0.001**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e─ Psychological Well-being\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e27.11 (5.80)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22.75 (4.64)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt; 0.001**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSituational Self-Awareness Scale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e37.24 (7.60)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e42.01 (10.10)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt; 0.001**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eTable 1 displays the baseline sociodemographic and clinical characteristics of participants in the Retreat and Control groups. There were no statistically significant differences between groups in age or gender distribution. Regarding psychological measures, the Retreat group exhibited significantly higher self-kindness (p = .005), lower isolation (p = .041), and lower depression (p = .002) scores at baseline compared to the Control group. The Retreat group also demonstrated higher levels of emotional, social, and psychological well-being, as measured by the MHC-SF, and lower situational self-awareness (all p \u0026lt; .001). No significant group differences were observed for common humanity, mindfulness, self-judgment, over-identification, anxiety and stress at baseline. See Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e for detailed means and standard deviation\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003e\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e \u003cb\u003eTable 2. Pre–Post Changes within Groups (Paired t-tests), Effect Sizes, and Confidence Intervals\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMeasure / Subscale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGroup\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMean Difference\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e95% CI\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003et\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eCohen’s d\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003e95% CI (d)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSelf-Compassion Scale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSelf-kindness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetreat\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-1.15, -0.58]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-6.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.73, -0.35]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-0.50, -0.02]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-2.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.031\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.27, -0.01]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCommon humanity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetreat\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-1.27, -0.66]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-6.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.81, -0.40]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-0.13, 0.37]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.343\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.06, 0.18]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMindfulness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetreat\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-0.79, -0.32]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-4.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.68, -0.27]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-0.19, 0.21]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.913\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.13, 0.15]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSelf-judgment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetreat\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[0.49, 1.16]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e4.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[0.25, 0.63]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-0.00, 0.52]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.053\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[0.00, 0.24]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIsolation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetreat\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[0.78, 1.44]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e6.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[0.41, 0.80]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-0.08, 0.38]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.187\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.03, 0.17]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOver-identification\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetreat\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[1.01, 1.65]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e8.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[0.49, 0.84]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[0.16, 0.67]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.002\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[0.07, 0.29]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSCS – Positive\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetreat\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-2.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-3.04, -1.75]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-7.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.86, -0.47]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-0.62, 0.36]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-0.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.597\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.14, 0.08]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSCS – Negative\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetreat\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[2.49, 4.04]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e8.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[0.49, 0.83]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[0.25, 1.40]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.005\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[0.04, 0.23]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDASS-21\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDepression\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetreat\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[2.20, 4.10]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e6.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[0.39, 0.76]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-0.69, 1.35]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.527\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.08, 0.16]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnxiety\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetreat\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[1.21, 3.29]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e4.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[0.20, 0.56]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-0.09, 2.09]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.072\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.01, 0.27]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStress\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetreat\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[5.50, 8.07]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e10.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[0.82, 1.33]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-0.33, 1.94]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.164\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.04, 0.22]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMHC – Short Form\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmotional Well-being\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetreat\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-1.13, -0.39]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-4.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.42, -0.14]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-0.43, 0.06]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-1.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.144\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.15, 0.02]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocial Well-being\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetreat\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-2.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-2.73, -1.35]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-5.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.55, -0.27]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-0.52, 0.19]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-0.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.365\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.11, 0.04]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePsychological Well-being\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetreat\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-2.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-2.78, -1.27]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-5.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.49, -0.22]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-0.72, 0.09]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-1.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.127\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.15, 0.02]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSituational Self-Awareness Scale\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSSAS – Total\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetreat\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-4.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-6.06, -3.19]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-6.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.86, -0.43]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[-0.79, 1.05]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.780\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e[-0.08, 0.10]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eAccording to Table\u0026nbsp;2, the retreat group, significant improvements were observed across most domains, including self-kindness, common humanity, mindfulness, and reductions in self-judgment and isolation (all p \u0026lt; .01, medium effect sizes). Notably, the retreat group showed a substantial decrease in stress (DASS-21), and improvements in all three domains of well-being (emotional, social, psychological) as measured by the MHC-SF. Similarly, large effect sizes were found for increases in positive self-compassion and reductions in negative self-compassion.\u003c/p\u003e\u003cp\u003eIn contrast, the Control group exhibited smaller or non-significant changes in most measures and limited change in most self-compassion and well-being dimensions (Cohen’s d mostly small). See Table\u0026nbsp;2 for full results.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of Pre-Post Change Scores (Δ) between Retreat and Control Groups\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInstrument / Variable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eΔRetreat\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eΔControl\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e95% CI\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003et\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCohen’s d\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003e95% CI (d)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSelf-Compassion Scale (SCS-SF)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSelf-kindness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[0.24, 0.97]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e[0.16,0.71]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCommon humanity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-0.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[0.69,1.48]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e[0.44, 1.00]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMindfulness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[-0.87, -0.26]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e[0.21,0.77]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSelf-judgment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-0.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[-0.14, -0.99]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-2.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e-0.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e[ -0.62, -0.07]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIsolation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-1.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-0.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[-0.55, -1.36]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-4.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e-0.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e[ -0.89, -0.33]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOver-identification\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-1.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-0.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[-0.51, -1.33]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-4.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e-0.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e[-0.87, -0.31]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePositive SCS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[1.46, 3.07]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e[0.45,1.01]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNegative SCS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-3.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-0.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[-1.48, -3.40]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-5.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e-0.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e[-0.94, -0.38]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDepression, Anxiety, Stress Scale (DASS-21)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDepression\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-3.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-0.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[-1.44, -4.21]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-4.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e-0.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e[-0.83,-0.28]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnxiety\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-2.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-1.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[0.25, -2.75]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-1.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.102\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e-0.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e[-0.50, -0.05]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStress\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-6.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-0.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[-4.27, -7.69]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-6.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e-0.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e[-1.21, -0.64]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMHC–Short Form\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmotional well-being\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[0.13, 1.02]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.012\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e[0.06, 0.60]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocial well-being\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[1.10,2.65]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e4.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e[0.33, 0.88]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePsychological well-being\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[0.86, 2.56]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e[0.23,0.78]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSituational Self-Awareness Scale (SSAS)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSSAS total\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[3.06, 6.45]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e[0.43, 0.99]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003e\u003cb\u003eNote\u003c/b\u003e. \u003cb\u003eΔ\u003c/b\u003e was computed as post − pre (post-intervention minus baseline). Positive Δ indicates an increase; negative Δ indicates a decrease. Between-group statistics compare change scores (Retreat − Control) using two-tailed Welch’s t-tests; 95% CIs refer to the between-group mean difference in Δ. Cohen’s d was computed with the pooled SD and is coded as Retreat − Control (sign follows the same direction). For interpretation, increases indicate improvement for SCS positive (self-kindness, common humanity, mindfulness), MHC-SF subscales, and SSAS; decreases indicate improvement for DASS-21 subscales and SCS negative (self-judgment, isolation, over-identification). Sample sizes: n = 120 (Retreat) and n = 92 Control).\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e summarizes the comparison of pre–post change scores (Δ = post − pre) between the Retreat and Control groups across all outcomes. For the SCS-SF, the Retreat group showed significantly greater improvements than the Control group. Specifically, in self-kindness the Retreat group exhibited a significantly larger increase (Δ = 0.87) than controls (Δ = 0.26), with a moderate effect size (d = 0.43, 95% CI [0.16, 0.71]; p = .001). Common humanity and mindfulness also increased significantly more in the Retreat group (Δ = 0.97 and 0.56, respectively; both p \u0026lt; .001), with effect sizes in the small-to-moderate range (d = 0.72 and 0.49, respectively). Self-judgment, isolation, and over-identification showed larger reductions in the Retreat group than in controls (all p ≤ .01), with small-to-moderate effects (d = 0.34–0.61). For the SCS composite scores, the Retreat group achieved greater increases in positive self-compassion (SCS-Positive: Δ = 2.39, d = 0.73, p \u0026lt; .001) and greater reductions in negative self-compassion (SCS-Negative: Δ = −3.27, d = − 0.66, p \u0026lt; .001).\u003c/p\u003e\u003cp\u003eFor the DASS-21, the Retreat group showed a significantly larger reduction in depression (Δ = −3.15) than controls (Δ = −0.33; d = − 0.55, p \u0026lt; .001). While both groups improved on anxiety, the between-group difference did not reach significance (p = .102), though the trend favored the Retreat group (Δ = −2.25 vs − 1.00). For stress, the Retreat group exhibited a marked reduction (Δ = −6.78 vs − 0.80; d = − 0.92, p \u0026lt; .001).\u003c/p\u003e\u003cp\u003eRegarding the MHC-SF, the Retreat group reported significantly greater increases in emotional well-being (Δ = 0.76 vs 0.18; d = 0.33, p = .012), social well-being (Δ = 2.04 vs 0.16; d = 0.61, p \u0026lt; .001), and psychological well-being (Δ = 2.03 vs 0.32; d = 0.50, p \u0026lt; .001).\u003c/p\u003e\u003cp\u003eOn the SSAS, the Retreat group demonstrated a substantial increase (Δ = 4.63), whereas the Control group showed no meaningful change (Δ = −0.13). The between-group difference was significant (d = 0.71, p \u0026lt; .001). Overall, the largest effects were observed for self-compassion, stress reduction, and well-being, underscoring the clinical relevance of the retreat intervention.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAdjusted Group Differences at Post-Test: ANCOVA Results for Outcomes with Baseline Differences\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOutcome\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGroup Effect (β [SE])\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003et\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePartial η² [95% CI]\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDepression (DASS-21)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3.93 (0.60)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.17 [0.10, 1.00]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSelf-kindness (SCS)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.87 (0.17)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-5.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.11 [0.05, 1.00]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIsolation (SCS)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.15 (0.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.15 [0.08, 1.00]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmotional Well-being (MHC-SF)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-1.14 (0.26)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-4.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.10 [0.08, 1.00]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocial Well-being (MHC-SF)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-2.83 (0.44)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-6.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.17 [0.10, 1.00]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePsychological Well-being (MHC-SF)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-2.78 (0.47)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-5.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt; .001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.14 [0.08, 1.00]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSituational Self-Awareness (SSAS)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-2.94 (0.83)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e-3.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.06 [0.02, 1.00]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cb\u003eNote. Models\u003c/b\u003e: \u003cem\u003epost ~ pre + group\u003c/em\u003e. The group effect (β) is coded as \u003cb\u003eControl − Retreat\u003c/b\u003e at post-test, controlling for baseline. Thus, for symptom scales (DASS-21), \u003cb\u003eβ \u0026gt; 0\u003c/b\u003e implies lower adjusted symptoms in the retreat group; for favorable constructs (SCS positive, MHC-SF, SSAS), \u003cb\u003eβ \u0026lt; 0\u003c/b\u003e implies higher adjusted scores in the retreat group.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e presents the adjusted group differences at post-test for all outcomes that showed baseline differences, as estimated by ANCOVA models controlling baseline scores.\u003c/p\u003e\u003cp\u003eAfter adjustment, the Retreat group showed lower adjusted post-test DASS-21 than the Control group (β = 3.93, SE = 0.60, t = 6.57, p \u0026lt; .001; partial η² = 0.17, 95% CI [0.10, 1.00]).\u003c/p\u003e\u003cp\u003eSCS was higher in the Retreat group at post-test (β = −0.87, SE = 0.17, t = − 5.17, p \u0026lt; .001; partial η² = 0.11), and Isolation (SCS) was lower (β = 1.15, SE = 0.19, t = 6.07, p \u0026lt; .001; partial η² = 0.15). Across the MHC-SF domains, the Retreat group showed higher adjusted post-test scores in Emotional (β = −1.14, SE = 0.26, t = − 4.39, p \u0026lt; .001; partial η² = 0.08), Social (β = −2.83, SE = 0.44, t = − 6.49, p \u0026lt; .001; partial η² = 0.17), and Psychological well-being (β = −2.78, SE = 0.47, t = − 5.93, p \u0026lt; .001; partial η² = 0.14). For Situational Self-Awareness (SSAS), the Retreat group also showed higher adjusted post-test scores (β = −2.94, SE = 0.83, t = − 3.54, p = .001; partial η² = 0.06). Using conventional benchmarks (η² ≈ .01 small, .06 medium, .14 large) (Richardson, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2011\u003c/span\u003e), effects ranged from medium to large, supporting the robustness of the intervention effects.\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe main objective of the present study was to evaluate the effects of a 5-day Zen retreat, as proposed by Marsha Linehan, on health professionals with previous training in DBT. This group was compared to a control group of health professionals, also trained in DBT, who attended psychoeducational dharma talks without meditation practice during the same period. The balance between change and acceptance is central in DBT (Linehan, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e1993b\u003c/span\u003e). While the goal of behaviour therapy is change the goal of Zen is simply mindful practice (Wolbert, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Even changes in the primary objective (i.e. symptom) are not intended, mindfulness could be understood as a transformation of the relationship between self and symptom (Sauer et al. \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2011\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThere is limited research exploring the effects of interventions in a retreat format within the mindfulness field, and none have been specifically designed around the Zen-derived principles of DBT, although Zen Buddhist philosophy is central to this contextual therapy. Additionally, the study gave us insight on this never studied DBT training component for health care workers already trained on DBT.\u003c/p\u003e\u003cp\u003eIntensive mindfulness practice is thought to decrease suffering, increase happiness, enhance mental control, and foster the ability to experience reality as it is, without delusion (Wolbert, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). When comparing the 5-day Zen retreat to our control condition on clinical indexes, the retreat group showed a significantly greater reduction in psychological distress. This is consistent with meta-analytic data that has shown that MBIs reduce psychological distress in non-clinical adults (Galante et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDepression scores were significantly reduced following the retreat. The effects of mindfulness practices on improving mood and affect are well-documented (Hofmann et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2010\u003c/span\u003e) and have been supported in subsequent metanalysis (Sommers-Spijkerman et al. \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). This was the case for depression and for stress, which showed moderate and large effect sizes, respectively. As depression research, several meta-analyses focusing on stress have reported benefits associated with MBIs (Grossman et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Pascoe et al, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). We wish to underscore the clinical relevance of reducing stress healthcare professionals, who are at high risk of suffering from it and experiencing burnout (e.g., Weinberg \u0026amp; Creed, \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2000\u003c/span\u003e). Findings from a meta-analysis have warned that healthcare providers dealing with suicidal behaviours, such is the case of DBT therapist, report high emotional exhaustion (O\u0026rsquo;Connor 2018) and have shown that the burnout level of the therapists were associated with an increased likelihood of unsafe self-care, unprofessional behaviors, and low patient satisfaction (Salyers et al. \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn the current study, with approximately one hundred individuals per arm, the Zen retreat condition yielded a large effect size improving quality of live among Health care workers in retreat condition. This is interesting since quality of current evidence in these population and mindfulness is less frequent and the data has been limited by small sample sizes studies (Burton et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Contrary to our expectations, we did not find equally pronounced decreases in anxiety when the two conditions were compared, although the trend favoured the retreat group. This result contrasts with some meta-analyses reporting moderate effects of meditation retreats on anxiety (Khoury et al. \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). However, Sommers-Spijkerman et al. (\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) metanalysis reported that while effects on depression and stress were moderate and statistically significant, the effect on anxiety was smaller. Overall, the improvements in affect, the reduction in stress, and the decreases in feelings of self-judgment and isolation suggest beneficial on clinical domines stemming from the meditation and silence condition compared to control condition without meditation but dharma talk.\u003c/p\u003e\u003cp\u003eIn our study, the data indicated higher levels of self-kindness, common humanity, and mindfulness, as well as improvements in all three assessed domains of mental health (i.e., emotional, social, and psychological). It is interesting to note the increase in self-compassion scores, as compassion-focused meditation is not an explicit component of a Zen retreat. Increases in self-compassion resulting from purely contemplative practices have been previously reported (Birnie et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Brito-Pons et al. \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Kuyken et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). In contrast to compassion training such as Mindful Self-Compassion (Neff \u0026amp; Germer, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2013\u003c/span\u003e) or Compassionate Mind Training (Gilbert \u0026amp; Procter, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2006\u003c/span\u003e) in MBIs or Zen retreat is often implicitly integrated as a foundational attitude in the instructors' interactions with participants (Kabat-Zinn, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e1990\u003c/span\u003e; Kuyken et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). Although it is widely acknowledged as a key attitudinal element of mindfulness practice, it is typically not directly instructed. Instead, instructors model a compassionate approach that participants can adopt in relating to their own experiences. In longer retreats, increases in cooperativeness (i.e. a sense of being helpful), compassionate feelings, and empathy have been reported, along with increases in positive and balanced affect (Montero-Marin et al. \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Rosenberg et al., \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). In shortened retreats, such as the present one, increased self-compassion has also been reported (Djernis et al. \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). This curiously happens even when restricted verbal or other social interactions were limited. In our study, high scores in social well-being indicate positive social functioning, a healthy relationship with one's community and society, and the belief that one has something important to offer the world. It also encompasses a sense of belonging, feeling supported by a community, acceptance of others, and the potential for societal growth (Keyes et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2008\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAcceptance, is a core element in DBT and in the retreat, refers to freedom from desiring that things should be different from what they are, and it is a necessary skill to acquire in the pursuit of joy. Is the willingness to experience life as it is, not how we want it to be. This not only should transform suffering also may leads to increase capacity for joy (Linehan,1993b). According to Linehan, this involves moving beyond knowing, and experiencing connection to the universe, towards essential goodness, and essential validity. Accessing to this joy is the final stage in (i.e. the fourth) DBT progression. The first two stages in DBT are clinically focused (i.e., behavioural control and emotional reprocessing), while the third and fourth are more related to positive affect (i.e., normal happiness and a sustained capacity for joy (Casellas et al., 2024). We were also interested in assessing positive affect and well-being variables. A metanalysis (Galante et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) and systematic review (Van Agteren et al. \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) found that MBIs not only significantly improve mental illness but also enhance well-being across a variety of samples. However, studies in non-clinical populations often exhibit greater heterogeneity and a higher risk of bias. This field of research requires further standardization of protocols, evaluation of cost-effectiveness, and expansion of access to maximize its potential as a preventive health tool (Van Agteren et al. \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Self-selection bias on retreat studies limits the generalizability of results, as retreat-goers often have higher initial motivation. Additional limitations include accessibility since many retreats are costly and time-consuming, limiting participation to privileged groups. Addressing these methodological, socioeconomic, and research gaps is essential for integrating retreats as accessible, effective tools in preventive healthcare (Giridharan, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eBeyond the social facet, the Zen retreat appears to promote other positive-oriented outcomes, such as psychological well-being and all positive polarities of self-compassion (i.e., common humanity, mindfulness, self-kindness), as well as situational self-awareness of both environmental and private experiences.\u003c/p\u003e\u003cp\u003eOur findings indicate that the intensive practice of mindfulness is associated with positive changes in the four measures used in this study and in 12 out of 14 of their subscales. Although some studies on retreats have reported occasional negative outcomes associated with retreat participation (Baer et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Lindahl et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Sedlmeier, 2018), in the current study, the impact on participants has been salutary.\u003c/p\u003e\u003cp\u003eFinally, it is important to highlight the relevance of the Zen mindfulness retreat for health professionals trained in DBT. This training component, which had not been previously evaluated, showed beneficial effects on clinical, quality of live and well-being domines. A future direction for research would be to determine whether this component of DBT training also enhances practitioners' efficiency in delivering the therapy, particularly in teaching mindfulness and acceptance skills to patients, and whether promotes or not later DBT model adoption (Navarro-Haro et al. \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) .\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding:\u003c/h2\u003e\u003cp\u003eNo funds, grants or other support was received.\u003c/p\u003e\u003cp\u003eThe authors have no conflicts of interest to declare that are relevant to the content of this article.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003e**KS:** recruited the study sample and contributed to writing the original draft and to review and editing. **MAM:** designed the study protocol and contributed to writing the original draft and to review and editing. **MA:** performed the formal analyses (applying statistical, mathematical, and other formal techniques to analyze and synthesize the data), curated the dataset, and contributed to writing the original draft and to review and editing. **RW:** delivered the intervention to the experimental group and contributed to writing the original draft and to review and editing. **JG:** contributed to writing the original draft and to review and editing. **VF:** recruited the study sample and contributed to writing the original draft and to review and editing. **JS:** designed the study protocol, supervised the study, and contributed to writing the original draft and to review and editing.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eWe would like to express our sincere gratitude to Geraldine Rodr\u0026iacute;guez for providing the resources that made it possible to recruit participants for the control group. Her contribution was essential to the completion of this study.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eData cannot be shared openly to protect study participant privacy.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBaer, R., Crane, C., Miller, E., \u0026amp; Kuyken, W. (2019). Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings. \u003cem\u003eClinical psychology review\u003c/em\u003e, \u003cem\u003e71\u003c/em\u003e, 101\u0026ndash;114. https://doi.org/10.1016/j.cpr.2019.01.001 \u003c/li\u003e\n\u003cli\u003eBirnie, K., Speca, M., \u0026amp; Carlson, L. (2010). Exploring self-compassion and empathy in the context of mindfulness-based stress reduction (MBSR). \u003cem\u003eStress and Health, 26\u003c/em\u003e(5), 359\u0026ndash;371. https://doi.org/10.1002/smi.1305. \u003c/li\u003e\n\u003cli\u003eBohus, M., Stoffers-Winterling, J., Sharp, C., Krause-Utz, A., Schmahl, C., \u0026amp; Lieb, K. (2021). Borderline personality disorder. \u003cem\u003eLancet (London, England)\u003c/em\u003e, \u003cem\u003e398\u003c/em\u003e(10310), 1528\u0026ndash;1540. https://doi.org/10.1016/S0140-6736(21)00476-1 \u003c/li\u003e\n\u003cli\u003eBrito-Pons, G., Campos, D., \u0026amp; Cebolla, A. (2018). Implicit or explicit compassion? Effects of compassion cultivation training and comparison with mindfulness-based stress reduction. \u003cem\u003eMindfulness, 9\u003c/em\u003e(5), 1494\u0026ndash;1508. https://doi.org/10.1007/s12671-018-0898-z.\u003c/li\u003e\n\u003cli\u003eBurton, A., Burgess, C., Dean, S., Koutsopoulou, G. Z., \u0026amp; Hugh-Jones, S. (2017). How Effective are Mindfulness-Based Interventions for Reducing Stress Among Healthcare Professionals? A Systematic Review and Meta-Analysis. \u003cem\u003eStress and health : journal of the International Society for the Investigation of Stress\u003c/em\u003e, \u003cem\u003e33\u003c/em\u003e(1), 3\u0026ndash;13. https://doi.org/10.1002/smi.2673\u003c/li\u003e\n\u003cli\u003eCarmona i Farr\u0026eacute;s, C., Elices, M., Soler, J., Dom\u0026iacute;nguez-Clav\u0026eacute;, E., Pomarol-Clotet, E., Salvador, R., \u0026amp; Pascual, J. C. (2019). Effects of mindfulness training on borderline personality disorder: Impulsivity versus emotional dysregulation. \u003cem\u003eMindfulness, 10\u003c/em\u003e(7), 1243\u0026ndash;1254. https://doi.org/10.1007/s12671-018-1071-4\u003c/li\u003e\n\u003cli\u003eCasellas-Pujol, E., Soler, J., Schmidt, C., Soria-Madrid, A., Elices, M., \u0026amp; Pascual, J. C. (2024). Contextual-compassion training for borderline personality disorder with long lasting symptoms: A randomized clinical trial. \u003cem\u003eJournal of Contextual Behavioral Science\u003c/em\u003e, \u003cem\u003e34\u003c/em\u003e, 100846.\u003c/li\u003e\n\u003cli\u003eCocker, F., \u0026amp; Joss, N. (2016). Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review. International journal of environmental research and public health, \u003cem\u003e13\u003c/em\u003e(6), 618. https://doi.org/10.3390/ijerph13060618. \u003c/li\u003e\n\u003cli\u003eDjernis, D., O\u0026apos;Toole, M. S., Fjorback, L. O., Svenningsen, H., Mehlsen, M. Y., Stigsdotter, U. K., \u0026amp; Dahlgaard, J. (2021). A Short Mindfulness Retreat for Students to Reduce Stress and Promote Self-Compassion: Pilot Randomised Controlled Trial Exploring Both an Indoor and a Natural Outdoor Retreat Setting. \u003cem\u003eHealthcare (Basel, Switzerland)\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(7), 910. https://doi.org/10.3390/healthcare9070910\u003c/li\u003e\n\u003cli\u003eEeles, J., \u0026amp; Walker, D. M. (2022). Mindfulness as taught in Dialectical Behaviour Therapy: A scoping review. \u003cem\u003eClinical psychology \u0026amp; psychotherapy\u003c/em\u003e, \u003cem\u003e29\u003c/em\u003e(6), 1843\u0026ndash;1853. https://doi.org/10.1002/cpp.2764\u003c/li\u003e\n\u003cli\u003eElices, M., Pascual, J. C., Portella, M. J., Feliu-Soler, A., Mart\u0026iacute;n-Blanco, A., Carmona, C., \u0026amp; Soler, J. (2016). Impact of mindfulness training on borderline personality disorder: A randomized trial. \u003cem\u003eMindfulness, 7\u003c/em\u003e(3), 584\u0026ndash;595. https://doi.org/10.1007/s12671-016-0492-1\u003c/li\u003e\n\u003cli\u003eGalante, J., Friedrich, C., Dawson, A. F., Modrego-Alarc\u0026oacute;n, M., Gebbing, P., Delgado-Su\u0026aacute;rez, I., Gupta, R., Dean, L., Dalgleish, T., White, I. R., \u0026amp; Jones, P. B. (2021). Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials. \u003cem\u003ePLoS medicine\u003c/em\u003e, \u003cem\u003e18\u003c/em\u003e(1), e1003481. https://doi.org/10.1371/journal.pmed.1003481\u003c/li\u003e\n\u003cli\u003eGilbert, P., \u0026amp; Procter, S. (2006). Compassionate Mind Training for People with High Shame and Self-Criticism: Overview and Pilot Study of a Group Therapy Approach. \u003cem\u003eClinical Psychology \u0026amp; Psychotherapy, 13\u003c/em\u003e(6), 353\u0026ndash;379. https://doi.org/10.1002/cpp.507.\u003c/li\u003e\n\u003cli\u003eGiridharan S. (2024). Residential Meditation Retreats: A Promise of Sustainable Well-Being?. \u003cem\u003eCureus\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e(11), e73326. https://doi.org/10.7759/cureus.73326. \u003c/li\u003e\n\u003cli\u003eGovern, J. M. \u0026amp; Marsch L. A. (2001). Development and validation of situational self-awareness scale. \u003cem\u003eConsciousness and Cognition\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e(3), 366-378. \u003c/li\u003e\n\u003cli\u003eGreenberg, L. S., Elliott, R., Watson, J. C., \u0026amp; Bohart, A. C. (2001). Empathy. \u003cem\u003ePsychotherapy: Theory, Research, Practice, Training\u003c/em\u003e, \u003cem\u003e38\u003c/em\u003e(4), 380\u0026ndash;384. https://doi.org/10.1037/0033-3204.38.4.380\u003c/li\u003e\n\u003cli\u003eGrepmair, L., Mitterlehner, F., Loew, T., \u0026amp; Nickel, M. (2007). Promotion of mindfulness in psychotherapists in training: Preliminary study. \u003cem\u003eEuropean Psychiatry\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e(8), 485-489. \u003c/li\u003e\n\u003cli\u003eGrossman, P., Niemann, L., Schmidt, S., \u0026amp; Walach, H. (2004). Mindfulness-based stress reduction and health benefits. A meta-analysis. \u003cem\u003eJournal of psychosomatic research\u003c/em\u003e, \u003cem\u003e57\u003c/em\u003e(1), 35\u0026ndash;43. https://doi.org/10.1016/S0022-3999(03)00573-7\u003c/li\u003e\n\u003cli\u003eHenry, J. D., \u0026amp; Crawford, J. R. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology,\u003cem\u003e44\u003c/em\u003e(2), 227\u0026ndash;239. https://doi.org/10.1348/014466505X29657. \u003c/li\u003e\n\u003cli\u003eHofmann, S. G., Sawyer, A. T., Witt, A. A., \u0026amp; Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. \u003cem\u003eJournal of consulting and clinical psychology\u003c/em\u003e, \u003cem\u003e78\u003c/em\u003e(2), 169\u0026ndash;183. https://doi.org/10.1037/a0018555\u003c/li\u003e\n\u003cli\u003eKabat-Zinn, J. (1990). \u003cem\u003eFull catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness\u003c/em\u003e. Delta. \u003c/li\u003e\n\u003cli\u003eKeyes, C. L. M. (2002). The Mental Health Continuum: From Languishing to Flourishing in Life. \u003cem\u003eJournal of Health and Social Behavior\u003c/em\u003e, \u003cem\u003e43\u003c/em\u003e(2), 207-222. https://doi.org/10.2307/3090197 \u003c/li\u003e\n\u003cli\u003eKeyes, C. L., Wissing, M., Potgieter, J. P., Temane, M., Kruger, A., \u0026amp; van Rooy, S. (2008). Evaluation of the mental health continuum-short form (MHC-SF) in setswana-speaking South Africans. \u003cem\u003eClinical psychology \u0026amp; psychotherapy\u003c/em\u003e, \u003cem\u003e15\u003c/em\u003e(3), 181\u0026ndash;192. https://doi.org/10.1002/cpp.572.\u003c/li\u003e\n\u003cli\u003eKhoury, B., Kn\u0026auml;uper, B., Schlosser, M., Carri\u0026egrave;re, K., \u0026amp; Chiesa, A. (2017). Effectiveness of traditional meditation retreats: A systematic review and meta-analysis. \u003cem\u003eJournal of psychosomatic research\u003c/em\u003e, \u003cem\u003e92\u003c/em\u003e, 16\u0026ndash;25. https://doi.org/10.1016/j.jpsychores.2016.11.006\u003c/li\u003e\n\u003cli\u003eKuyken, W., Watkins, E., Holden, E., White, K., Taylor, R. S., Byford, S., Evans, A., Radford, S., Teasdale, J. D., \u0026amp; Dalgleish, T. (2010). How does mindfulness-based cognitive therapy work?. \u003cem\u003eBehaviour research and therapy\u003c/em\u003e, \u003cem\u003e48\u003c/em\u003e(11), 1105\u0026ndash;1112. https://doi.org/10.1016/j.brat.2010.08.003\u003c/li\u003e\n\u003cli\u003eLambert, M. J., \u0026amp; Barley, D. E. (2002). Research summary on the therapeutic relationship and psychotherapy outcome. In J. C. Norcross (Ed.), \u003cem\u003ePsychotherapy relationships that work: Therapist contributions and responsiveness to patients\u003c/em\u003e (17\u0026ndash;32). Oxford University Press.\u003c/li\u003e\n\u003cli\u003eLamers, S. M., Westerhof, G. J., Bohlmeijer, E. T., ten Klooster, P. M., \u0026amp; Keyes, C. L. (2011). Evaluating the psychometric properties of the Mental Health Continuum-Short Form (MHC-SF). \u003cem\u003eJournal of clinical psychology\u003c/em\u003e, \u003cem\u003e67\u003c/em\u003e(1), 99\u0026ndash;110. https://doi.org/10.1002/jclp.20741 \u003c/li\u003e\n\u003cli\u003eLau, M. A., \u0026amp; McMain, S. F. (2005). Integrating mindfulness meditation with cognitive and behavioural therapies: The challenge of combining acceptance-and change-based strategies. \u003cem\u003eThe Canadian Journal of Psychiatry\u003c/em\u003e, \u003cem\u003e50\u003c/em\u003e(13), 863-869. \u003c/li\u003e\n\u003cli\u003eLindahl, J. R., Fisher, N. E., Cooper, D. J., Rosen, R. K., \u0026amp; Britton, W. B. (2017). The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists. \u003cem\u003ePloS one\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e(5), e0176239. https://doi.org/10.1371/journal.pone.0176239 \u003c/li\u003e\n\u003cli\u003eLinehan, M. M. (1993a). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.\u003c/li\u003e\n\u003cli\u003eLinehan, M. M. (1993b). Skills training manual for treating borderline personality disorder. Guilford Press.\u003c/li\u003e\n\u003cli\u003eLinehan, M. M. (2014). DBT skills training manual (2nd ed.). Guilford Press.\u003c/li\u003e\n\u003cli\u003eLovibond, P. F., \u0026amp; Lovibond, S. H. (1995). The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. \u003cem\u003eBehaviour research and therapy\u003c/em\u003e, \u003cem\u003e33\u003c/em\u003e(3), 335\u0026ndash;343. https://doi.org/10.1016/0005-7967(94)00075-u \u003c/li\u003e\n\u003cli\u003eMontero-Marin, J., Puebla-Guedea, M., Herrera-Mercadal, P., Cebolla, A., Soler, J., Demarzo, M., Vazquez, C., Rodr\u0026iacute;guez-Bornaetxea, F., \u0026amp; Garc\u0026iacute;a-Campayo, J. (2016). Psychological Effects of a 1-Month Meditation Retreat on Experienced Meditators: The Role of Non-attachment. \u003cem\u003eFrontiers in psychology\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e, 1935. https://doi.org/10.3389/fpsyg.2016.01935\u003c/li\u003e\n\u003cli\u003eNavarro-Haro, M. V., Harned, M. S., Korslund, K. E., DuBose, A., Chen, T., Ivanoff, A., \u0026amp; Linehan, M. M. (2019). Predictors of Adoption and Reach Following Dialectical Behavior Therapy Intensive Training\u0026trade;. \u003cem\u003eCommunity mental health journal\u003c/em\u003e, \u003cem\u003e55\u003c/em\u003e(1), 100\u0026ndash;111. https://doi.org/10.1007/s10597-018-0254-8 \u003c/li\u003e\n\u003cli\u003eNeff, K. D. (2003). Development and validation of a scale to measure self-compassion. \u003cem\u003eSelf and Identity\u003c/em\u003e, 2, 223-250. \u003c/li\u003e\n\u003cli\u003eNeff, K. D., \u0026amp; Germer, C. K. (2013). A pilot study and randomized controlled trial of the mindful self-compassion program. \u003cem\u003eJournal of clinical psychology\u003c/em\u003e, \u003cem\u003e69\u003c/em\u003e(1), 28\u0026ndash;44. https://doi.org/10.1002/jclp.21923\u003c/li\u003e\n\u003cli\u003eNutting, R., Ofei-Dodoo, S., Rose-Borcherding, K., \u0026amp; Strella, G. (2022). Brief Mindfulness Intervention for Emotional Distress, Resilience, and Compassion in Family Physicians During COVID-19: A Pilot Study. \u003cem\u003ePRiMER (Leawood, Kan.)\u003c/em\u003e, \u003cem\u003e6\u003c/em\u003e, 3. https://doi.org/10.22454/PRiMER.2022.746202\u003c/li\u003e\n\u003cli\u003eO\u0026apos;Connor, K., Muller Neff, D., \u0026amp; Pitman, S. (2018). Burnout in mental health professionals: A systematic review and meta-analysis of prevalence and determinants. \u003cem\u003eEuropean psychiatry : the journal of the Association of European Psychiatrists\u003c/em\u003e, \u003cem\u003e53\u003c/em\u003e, 74\u0026ndash;99. https://doi.org/10.1016/j.eurpsy.2018.06.003 \u003c/li\u003e\n\u003cli\u003ePascoe, M. C., Thompson, D. R., Jenkins, Z. M., \u0026amp; Ski, C. F. (2017). Mindfulness mediates the physiological markers of stress: Systematic review and meta-analysis. \u003cem\u003eJournal of psychiatric research\u003c/em\u003e, 95, 156\u0026ndash;178. https://doi.org/10.1016/j.jpsychires.2017.08.004.\u003c/li\u003e\n\u003cli\u003eRaes, F., Pommier, E., Neff, K. D., \u0026amp; Van Gucht, D. (2011). Construction and factorial validation of a short form of the Self-Compassion Scale. \u003cem\u003eClinical psychology \u0026amp; psychotherapy\u003c/em\u003e, \u003cem\u003e18\u003c/em\u003e(3), 250\u0026ndash;255. https://doi.org/10.1002/cpp.702 \u003c/li\u003e\n\u003cli\u003eRazzaque, R., \u0026amp; Wood, L. (2016). Exploration of the effectiveness and acceptability of a professional mindfulness retreat for psychiatrists. \u003cem\u003eMindfulness, 7\u003c/em\u003e(2), 340\u0026ndash;348. https://doi.org/10.1007/s12671-015-0443-2\u003c/li\u003e\n\u003cli\u003eRichardson, J. T. E. (2011). Eta squared and partial eta squared as measures of effect size in educational research. \u003cem\u003eEducational Research Review, 6\u003c/em\u003e(2), 135\u0026ndash;147.\u003c/li\u003e\n\u003cli\u003eRobins, C. J. (2002). Zen principles and mindfulness practice in dialectical behavior therapy. \u003cem\u003eCognitive and behavioral practice\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(1), 50-57. \u003c/li\u003e\n\u003cli\u003eRosenberg, E. L., Zanesco, A. P., King, B. G., Aichele, S. R., Jacobs, T. L., Bridwell, D. A., MacLean, K. A., Shaver, P. R., Ferrer, E., Sahdra, B. K., Lavy, S., Wallace, B. A., \u0026amp; Saron, C. D. (2015). Intensive meditation training influences emotional responses to suffering. \u003cem\u003eEmotion, 15\u003c/em\u003e(6), 775\u0026ndash;790. https://doi.org/10.1037/emo0000080\u003c/li\u003e\n\u003cli\u003eSalyers, M. P., Bonfils, K. A., Luther, L., Firmin, R. L., White, D. A., Adams, E. L., \u0026amp; Rollins, A. L. (2017). The Relationship Between Professional Burnout and Quality and Safety in Healthcare: A Meta-Analysis. \u003cem\u003eJournal of general internal medicine\u003c/em\u003e, \u003cem\u003e32\u003c/em\u003e(4), 475\u0026ndash;482. https://doi.org/10.1007/s11606-016-3886-9 \u003c/li\u003e\n\u003cli\u003eSauer, S., Lynch, S., Walach, H., \u0026amp; Kohls, N. (2011). Dialectics of mindfulness: implications for western medicine. \u003cem\u003ePhilosophy, ethics, and humanities in medicine : PEHM\u003c/em\u003e, \u003cem\u003e6\u003c/em\u003e, 10. https://doi.org/10.1186/1747-5341-6-10\u003c/li\u003e\n\u003cli\u003eSchmidt, C., Soler, J., Carmona I Farr\u0026eacute;s, C., Elices, M., Dom\u0026iacute;nguez-Clav\u0026eacute;, E., Vega, D., \u0026amp; Pascual, J. C. (2021). Mindfulness in Borderline Personality Disorder: Decentering Mediates the Effectiveness. \u003cem\u003ePsicothema\u003c/em\u003e, \u003cem\u003e33\u003c/em\u003e(3), 407\u0026ndash;414. https://doi.org/10.7334/psicothema2020.437\u003c/li\u003e\n\u003cli\u003eSedlmeier, P., Lo\u0026szlig;e, C., \u0026amp; Quasten, L. C. (2018). Psychological effects of meditation for healthy practitioners: an update. \u003cem\u003eMindfulness\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(2), 371-387. \u003c/li\u003e\n\u003cli\u003eShapiro, S. L., Carlson, L. E., Astin, J. A., \u0026amp; Freedman, B. (2006). Mechanisms of mindfulness. \u003cem\u003eJournal of clinical psychology\u003c/em\u003e, \u003cem\u003e62\u003c/em\u003e(3), 373\u0026ndash;386. https://doi.org/10.1002/jclp.20237\u003c/li\u003e\n\u003cli\u003eSoler, J., Elices, M., Pascual, J. C., Mart\u0026iacute;n-Blanco, A., Feliu-Soler, A., Carmona, C., \u0026amp; Portella, M. J. (2016). Effects of mindfulness training on different components of impulsivity in borderline personality disorder: results from a pilot randomized study. \u003cem\u003eBorderline personality disorder and emotion dysregulation\u003c/em\u003e, \u003cem\u003e3\u003c/em\u003e, 1. https://doi.org/10.1186/s40479-015-0035-8\u003c/li\u003e\n\u003cli\u003eSoler, J., Arqueros, M., Schmidt, C., Otero, D., Soria-Madrid, A., Campins, M. J., Catalan, A., Casellas, E., Espeso, R., \u0026amp; Pascual, J. C. (2025). Scale to measure dialectical thinking from Dialectical Behavior Therapy perspective. \u003cem\u003eEuropean Journal of Psychiatry, 39\u003c/em\u003e(2). https://doi.org/10.1016/j.ejpsy.2025.100305 \u003c/li\u003e\n\u003cli\u003eSommers-Spijkerman, M., Austin, J., Bohlmeijer, E., \u0026amp; Pots, W. (2021). New Evidence in the Booming Field of Online Mindfulness: An Updated Meta-analysis of Randomized Controlled Trials. \u003cem\u003eJMIR mental health\u003c/em\u003e, \u003cem\u003e8\u003c/em\u003e(7), e28168. https://doi.org/10.2196/28168\u003c/li\u003e\n\u003cli\u003eVan Agteren, J., Iasiello, M., Lo, L., Bartholomaeus, J., Kopsaftis, Z., Carey, M., \u0026amp; Kyrios, M. (2021). A systematic review and meta-analysis of psychological interventions to improve mental wellbeing. \u003cem\u003eNature human behaviour\u003c/em\u003e, \u003cem\u003e5\u003c/em\u003e(5), 631-652. \u003c/li\u003e\n\u003cli\u003eWeinberg, A., \u0026amp; Creed, F. (2000). Stress and psychiatric disorder in healthcare professionals and hospital staff. \u003cem\u003eLancet (London, England)\u003c/em\u003e, \u003cem\u003e355\u003c/em\u003e(9203), 533\u0026ndash;537. https://doi.org/10.1016/S0140-6736(99)07366-3 \u003c/li\u003e\n\u003cli\u003eWolbert, R. (2017). \u003cem\u003eModifying behaviour therapy to meet the challenge of treating borderline personality disorder: Incorporating Zen and mindfulness\u003c/em\u003e. En M. A. Swales (Ed.), \u003cem\u003eThe Oxford handbook of dialectical behaviour therapy\u003c/em\u003e. Oxford University Press. https://doi.org/10.1093/oxfordhb/9780198758723.013.5 \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Dialectical Behavior Therapy, Zen Retreat, Healthcare Workers, Mindfulness","lastPublishedDoi":"10.21203/rs.3.rs-7750231/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7750231/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eDialectical Behavior Therapy (DBT) integrates mindfulness and dialectics, yet the contribution of a residential Zen-style mindfulness retreat for clinicians has seldom been evaluated.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eWe conducted a nonrandomized controlled study with 212 DBT-trained mental health professionals (Retreat\u0026thinsp;=\u0026thinsp;120; Control\u0026thinsp;=\u0026thinsp;92). The intervention was a 5-day, silent residential retreat with intensive formal and informal mindfulness practice; controls listened to daily Dharma, without meditation, over the same period. Self-report outcomes were assessed pre and post intervention.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eRelative to controls, the retreat produced greater increases in self-compassion areas such self-kindness (Δ\u0026thinsp;=\u0026thinsp;0.87 vs 0.26, d\u0026thinsp;=\u0026thinsp;0.43, p\u0026thinsp;=\u0026thinsp;.001), common humanity (0.97 vs \u0026minus;\u0026thinsp;0.12, d\u0026thinsp;=\u0026thinsp;0.72, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), and mindfulness (0.56 vs 0.01, d\u0026thinsp;=\u0026thinsp;0.49, p\u0026thinsp;\u0026lt;\u0026thinsp;.001) and larger reductions in negative facets such self-judgment, isolation, over-identification (d\u0026thinsp;=\u0026thinsp;0.34\u0026ndash;0.61, all p\u0026thinsp;\u0026le;\u0026thinsp;.01). The retreat yielded greater reductions in depression (Δ = \u0026minus;3.15 vs \u0026minus;\u0026thinsp;0.33, d\u0026thinsp;=\u0026thinsp;0.55, p\u0026thinsp;\u0026lt;\u0026thinsp;.001) and stress (\u0026minus;\u0026thinsp;6.78 vs \u0026minus;\u0026thinsp;0.80, d\u0026thinsp;=\u0026thinsp;0.92, p\u0026thinsp;\u0026lt;\u0026thinsp;.001). Well-being increased more in the retreat across emotional, social, and psychological domains (d\u0026thinsp;=\u0026thinsp;0.33\u0026ndash;0.61, all p\u0026thinsp;\u0026le;\u0026thinsp;.012) and situational self-awareness increased substantially (Δ\u0026thinsp;=\u0026thinsp;4.63 vs \u0026minus;\u0026thinsp;0.13, d\u0026thinsp;=\u0026thinsp;0.71, p\u0026thinsp;\u0026lt;\u0026thinsp;.001).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eA 5-day Zen mindfulness retreat produced clinically meaningful improvements both in clinical and wellbeing indexes beyond psychoeducation Dharma talks alone. Findings support the retreat as a beneficial component for DBT-practicing clinicians and could be a protentional promoting training component for DBT.\u003c/p\u003e","manuscriptTitle":"The Effects of Dialectical Behaviour Therapy Zen retreat on healthcare workers","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-28 16:41:48","doi":"10.21203/rs.3.rs-7750231/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"53d1e6cc-df07-4de6-a192-f85b0cc62268","owner":[],"postedDate":"October 28th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-05-26T10:10:41+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-28 16:41:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7750231","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7750231","identity":"rs-7750231","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}