An Online, Compassion Intervention for Adults With Type 1 and Type 2 Diabetes Mellitus (T1DM; T2DM).

An Online, Compassion Intervention to Improve Shame, Self-criticism, and Physical Wellbeing in Adults With Type 1 and Type 2 Diabetes Mellitus (T1DM; T2DM)

The goal of this research study is to evaluate a programme that is based on Compassionate Mind Training (CMT) over four-weeks. The programme intends to share information and strategies to reduce diabetes distress, self-criticism, and shame, and improve physical health in people who have Type 1 and Type 2 Diabetes Mellitus.

This Randomised Controlled Trial (RCT) will compare a CMT intervention for people with Type 1 and Type 2 Diabetes Mellitus with a waitlist control group who will be given access after the study. The outcome measures will be completed at baseline (week 0), post-intervention (week 4), and at follow-up (week 8).

All the outcome measures will be self-report questionnaires that will be completed by an online automated system with no involvement of the research team.

Control participants will receive no intervention during the study but will be given the option of accessing the online self-compassion intervention after the study is complete.

This is a four-week self-compassion course supplied by Balanced Minds. The owner of Balanced Minds is a Consultant to this study, who will be providing access to participants. The self-help, self-compassion course is based on Compassionate Mind Training. This provides participants with opportunities to develop skills and attributes of compassion through a weekly 30-minute video on a specified topic, a 10-minute compassionate exercise that participants are encouraged to engage in daily for the week and a brief summary of the compassionate topic. The topics of the course are: The Foundations of Self-Compassion Developing your Compassionate Self Deepening the Compassionate Relationship with Yourself Self-compassion in Everyday Life.

The DDS is a 17-item measure of problems and hassles related to diabetes. The DDS establishes a total mean score and a mean score for its four sub-scales. Scores will range from 1 to 6. Mean scores of 3 or above is considered distress worthy of clinical attention.

Change in the total score on the External and Internal Shame Scale (EISS) from baseline (week 0) to post-intervention (week 4).

The EISS is an eight-item scale measuring external and internal dimensions of shame. Higher scores indicate higher levels of shame and a total score varies between 8 and 40.

Change in Forms of Self-Criticising/Attacking and Self-Reassuring Scale (FSCRS) scores from baseline (week 0) to post-intervention (week 4).

The FSCRS is a 22-item scale with statements measuring inadequate self, hated self and reassured self. Scores will range from 0 to 88.

Change in Fears of Compassion Scale (FCS) scores from baseline (week 0) to post-intervention (week 4).

The FCS is a 15-item measure of fear of compassion towards self. Scores will range from 0 to 60. Higher scores indicate greater fear of compassion.

Change in Warwick-Edinburgh Mental Wellbeing Scales (WEMWBS) scores at baseline (week 0) and post-intervention (week 4).

14-item measure assessing mental wellbeing in the non-clinical sample. Scores on the WEMWBS will range from 14 to 70. Higher scores indicate greater positive mental wellbeing.

Change in Compassionate Engagement and Action Scale (CEAS) scores at baseline (week 0) and post-intervention (week 4).

The CEAS is a 13-item measure of compassionate engagement and action. The engagement sub-scale will establish a score between 6 and 60. The action sub-scale will establish a score between 4 and 40.

Participants will be asked to self-report a blood glucose (HbA1c) level taken by a healthcare provider in the past three to six months at baseline and at one-month post-intervention. Higher HbA1c levels indicate poorer diabetes control.

Change in Warwick-Edinburgh Mental Wellbeing Scales (WEMWBS) scores at baseline (week 0) and follow-up (week 8).

Change in the total score on the External and Internal Shame Scale (EISS) from baseline (week 0) to follow-up (week 8).

Change in Forms of Self-Criticising/Attacking and Self-Reassuring Scale (FSCRS) scores from baseline (week 0) to follow-up (week 8).

Change in Compassionate Engagement and Action Scale (CEAS) scores at baseline (week 0) to follow-up (week 8).

Inclusion Criteria: Resident in the United Kingdom; Clinician diagnosed Type 1 Diabetes Mellitus or Type 2 Diabetes Mellitus; Self-managing condition; Diabetes diagnosed over a year ago. Exclusion Criteria: Diagnosis of Gestational Diabetes or Pre-Diabetes. Current severe mental health condition; Currently self-harming or suicidal; Currently engaging in psychological therapy.

Anonymised data would be made available to researchers on reasonable request after the study findings have been published.