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NCT Number: NCT07407413

Online Socio-emotional Dyad Training for Healthcare Students' Well-being and Social Skills

In this Edu:Social Health Care project, a randomized controlled trial with a socio-emotional intervention and a waitlist control group will be conducted to evaluate the effects of a partner-based empathy-compassion Dyad mental training (EmCo) intervention on healthcare students with regard to the following primary outcome domains: 1) mental health, 2) resilience, 3) social cohesion and support, 4) social skills, 5) coping and emotion regulation, and 6) social behaviors.

One main goal is to examine the effects of such adapted 8-week EmCo Dyad intervention within the health care context, with a particular focus on strengthening students' mental health, resilience, social skills and behaviors, and social cohesion as well as fostering interprofessional attitudes by pairing every week study partners across different healthcare disciplines with each other for practicing their daily Dyads (e.g., nursing students will practice daily via app with medical students).

A further aim is to validate the novel Dyad Voice Assessment (DYVA) task, which explores the use of app-based voice recordings as indicators of students' emotional states during their daily partner-based Dyad practice. By combining students' self-reported practice-related emotions with partner-based evaluations, this approach aims to generate new and innovate, more objective markers of training-induced changes in emotional processing and regulation over time in a real-live applied setting.

The final aim is to investigate the cognitive and affective mechanisms and factors underlying observed changes in students' mental health, resilience, social cohesion, social skills and social behaviors, that may explain observed training-related effects in primary outcome domains. Based on previous research, we expect the socio-emotional EmCo Dyad training to activate evolutionary old care- and affiliation-based motivational systems that foster positive affect and motivation, acceptance, trust social capacities and behavioral tendencies. These processes should go along with reduction in loneliness, stress and other mental vulnerabilities (anxiety, depression, burn-out etc.) and foster social skills such as empathy, compassion as well as social cohesion and resilience.

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Key information

Conditions

Intervention Condition Behavior Control (Delayed Training) Condition Personal Satisfaction Psychological Well-Being

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Social Neuroscience Lab, Max Planck Society

Berlin, Germany

About this study

One-quarter to one-third of university students experience a common mental health disorder each year, with evidence indicating rising distress and declining well-being over time. Healthcare students appear particularly vulnerable, showing increasing levels of burnout associated with poorer academic engagement and impaired professional development. Mindfulness- and compassion-based interventions, as well as socio-emotional learning programs, have shown promise in improving mental health outcomes such as depression, anxiety, stress, and burnout, and in strengthening resilience among healthcare students.

In recent years, classic mindfulness-based interventions focusing on individual mental practices have been expanded to include partner-based social practices, known as Dyads, which particularly target social skills such as empathy, (self-)compassion, and social cohesion. However, despite growing research on student well-being, partner-based Dyadic interventions have not yet been systematically investigated in healthcare student populations. Available evidence suggests that Dyads may be more effective than solitary mindfulness practices in reducing loneliness and social stress, strengthening social connection and cohesion, and enhancing resilience and optimism. Moreover, findings indicate that dyadic social practices engage mechanisms that differ from those underlying traditional mindfulness-based interventions.

Empathy, (self-)compassion, and deep listening are core socio-emotional skills in healthcare, supporting effective communication and emotional understanding. However, empathy can lead to empathic distress when individuals are repeatedly exposed to others' suffering, whereas compassion is considered more protective, as it relies on altruistic and care-based motivational systems associated with positive affect and regulatory processes that buffer emotional overwhelm. Despite this distinction, empathy and compassion have not yet been systematically taught to healthcare students in an evidence-based manner. To address this gap, the Edu:Social Health Care project implements the empathy-compassion Dyad training program (EmCo), which trains students to distinguish between empathy and empathic listening and empathy regulation to avoid moving into empathic distress during the first four weeks, and (self)compassion and compassionate listening during the subsequent four weeks.

The EmCo program builds on the Affect Dyad developed in the ReSource project and the online Dyad coaching format implemented in the CovSocial project, both of which demonstrated the effectiveness of partner-based dyadic mental training in inducing brain plasticity, reducing stress, enhancing psychological resilience, and strengthening social cohesion across multiple indicators of biopsychosocial health. In contrast, to the ReSource and CovSocial projects, the present program, includes a novel empathy versus compassion listening component to it. Further, compared with earlier 10-week online Dyad programs, EmCo reduces the intervention duration to eight weeks, aligning with standard mindfulness-based interventions such as MBSR and MBCT and improving feasibility for implementation in healthcare and educational settings.

Accordingly, the study is implemented as a randomized controlled trial in a sample of healthcare students (target N = 360). A multimethod assessment strategy will be used, including self-report validated trait and state questionnaires, behavioral computer tasks delivered at home through webapp, and ecological momentary assessment (EMA) methods based on push-notifications by the app. These different assessments are capturing changes across mental health, resilience, social cohesion and support, social skills, coping and emotion regulation, and social behaviors (e.g., listening, attachment behaviors).

After providing informed consent, participants will be randomized to one of two groups: (1) an empathy-compassion training group (EmCo), based on the Affect Dyad mental practice, or (2) a waitlist control group (WCG). All participants will first complete the pre-test assessment phase including baseline psychometrics, computer-based tasks, and EMA measures. The intervention group will then be onboarded into the intervention with two Online onboarding I and II sessions lead by professional Dyad teachers and then complete the EmCo training program delivered via a dedicated web and smartphone application with daily partner-based Dyads as well as weekly 1.5 hours online coaching sessions. During this period, participants will complete brief weekly self-report questionnaires, Ecological Momentary Assessments (EMA) and daily pre-post Dyad practice ratings (DPR), to capture changes in key psychological and social processes to be used as mediator variables. At the end of the intervention, all participants will complete a post-test phase similar to the pre-test but with an additional final feedback questionnaire.

Following completion of the initial post-test (T1), participants in the waitlist control group will subsequently receive the same 8-week socio-emotional Dyad intervention (EmCo) and complete an additional post-test assessment (T2).

The study was preregistered on the Open Science Framework (OSF) and is publicly available at https://osf.io/3t8s4.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Between 18- and 65-years old.
  • actively enrolled student at the PMU.
  • Proficient in German.
  • Informed consent.
  • No symptoms of psychiatric disease within the past two years.
  • Stable internet access and necessary technical equipment (computer or laptop or tablet, and mobile phone with internet access).
  • No regular contemplative practice (≤ 50 hours total within the past six months); healthy population, non-clinical population.

Exclusion criteria

  • Insufficient German proficiency.
  • Lack of stable internet access or required devices (computer or laptop or tablet, and mobile phone with internet access).
  • No informed consent.
  • Not actively enrolled at PMU.
  • Regular contemplative practice (> 50 hours in the past six months (e.g., dyad, mindfulness, compassion-based practices).
  • Current psychiatric diagnosis or therapy, or reaching screening cutoffs on:
  • Patient Health Questionnaire-9 (PHQ-9; Martin et al., 2006; Löwe et al., 2004; Cutoff ≥ 10),
  • Generalized Anxiety Disorder-7 (GAD-7; Löwe et al., 2007; Spitzer et al., 2006; Cutoff ≥ 10),
  • Toronto Alexithymia Scale-20 (TAS-20; Bagby et al., 1994; Ritz & Kannapin, 2000; Cutoff ≥ 61)
  • Standardized Assessment of Personality - Abbreviated Scale (SAPAS; Moran et al., 2003; Söchtig et al., 2012, Cutoff ≥ 4).
  • Moreover, participants endorsing suicidality on the PHQ-9 will be excluded.

Treatment and study plan

Experimental: Empathy- and compassion-based socio-emotional mental training (EmCo)

Behavioral
  • Participants engage in a structured 13-minute partner-based contemplative exercise. Each dyad reflects on two experiences from the previous 24 hours: one involving a difficult emotion and one involving gratitude. Partners take turns speaking while the other listens non-judgmentally. During weeks 1-4, the practice emphasizes empathic listening; during weeks 5-8, compassionate listening. Participants are instructed to attend to bodily sensations associated with the emotions described. The practice aims to improve coping with difficult emotions, empathic and compassionate listening, (self)acceptance, compassion, gratitude, resilience.
  • Participants also attend eight 1.5-hour online group sessions led by Expert Dyad teachers. The coaching sessions help deepen the Dyad practice and educate teachers about body language, coping better with difficult emotions/stress, the benefits of empathy versus compassion and the act of listening from a mindset of empathy versus compassion.

Waitlist Control Group (WCG)

Other

Participants in the control group will not receive the intervention. They will complete pre- and post-test procedures consisting primarily of self-report questionnaires, and behavioral tasks, as well as ecological momentary assessment (EMA) conducted on four days within two weeks at pre-test and post-test 1 & 2.

Primary outcomes

  1. Depression Anxiety Stress Scale (DASS-21)

    Time frame: Assessed at baseline (pre-test) and after the 8-week intervention period (post-test 1 & 2)

    A scale measuring depression, anxiety, and stress (Henry & Crawford, 2005; Nilges & Essau, 2021). Higher scores indicate more depression, anxiety, and stress.

  2. Maslach Burnout Inventory-Students Survey (MBI-SS)

    Time frame: Assessed at baseline (pre-test) and after the 8-week intervention period (post-test 1 & 2)

    A scale measuring burnout (Gumz et al., 2013; Maslach & Jackson, 1981). Higher scores indicate more burnout.

  3. UCLA Loneliness Scale (UCLA)

    Time frame: Assessed at baseline (pre-test) and after the 8-week intervention period (post-test 1 & 2)

    A scale measuring loneliness severity (Döring & Bortz, 1993; Russell et al., 1980). Higher scores indicate more loneliness.

  4. Connor Davidson Resilience Scale (CD-RISC)

    Time frame: Assessed at baseline (pre-test) and after the 8-week intervention period (post-test 1 & 2)

    A scale measuring psychological resilience (Connor & Davidson, 2003; Sarubin et al., 2015). Higher scores indicate more resilience.

  5. Social closeness (IOS per profession)

    Time frame: Assessed at baseline (pre-test) and after the 8-week intervention period (post-test 1 & 2)

    A scale measuring the felt closeness between persons or groups/communities using a visual representation (Aron et al., 1992; Kinnunen & Windmann, 2013). Higher score indicates more social closeness.

  6. Interprofessionalism Scale (IPAS-D)

    Time frame: Assessed at baseline (pre-test) and after the 8-week intervention period (post-test 1 & 2)

    A scale (Norris et al., 2015; Pedersen et al., 2020) measuring attitudes that relate to the Core Competencies for Interprofessional Collaborative Practice (IPEC Report, 2011). Higher scores indicate more positive attitudes toward collaborative practice.

  7. Social Support Scale (F-SozU K-6)

    Time frame: Assessed at baseline (pre-test) and after the 8-week intervention period (post-test 1 & 2)

    A scale measuring the subjective feeling of having support available (Kliem et al., 2015). Higher scores indicate greater perceived social support.

  8. Socio-Affective Video Task (SoVT)

    Time frame: Assessed at baseline (pre-test), after 4 weeks of empathic listening training (mid-intervention) and after the 4 weeks of compassionate listening training (post-test 1 & 2)

    This task assesses behavioral empathy and compassion using emotional video clips (Klimecki et al., 2014). Higher scores indicate more empathy or more compassion.

  9. Sussex-Oxford Compassion Scale for Self and Others (SOCS)

    Time frame: Assessed at baseline (pre-test), after 4 weeks of empathic listening training (mid-intervention) and after the 4 weeks of compassionate listening training (post-test 1 & 2)

    A scale measuring self-compassion (SOCS-S) and compassion for others (SOCS-O; Gu et al., 2020). Higher scores indicate more compassion.

  10. Mentalization Scale (MENTS)

    Time frame: Assessed at baseline (pre-test) and after the 8-week intervention period (post-test 1 & 2).

    A scale measuring the capacity of envisioning one's and others' behaviors with reference to the underlying mental states (Dimitrijević et al., 2018). Higher scores suggesting a more sophisticated capacity for mentalizing.

  11. Prosodic Features of Vocalized Emotional Expressions

    Time frame: Assessed weekly from week 1 to week 8, as part of the Dyad Voice Assessment (DYVA)

    Acoustic assessment of prosodic speech features during participants' daily Dyad practice, analyzed using audEERING devAIce software. The following parameters will be assessed: pitch (Hz), loudness (unitless), speaking rate (syllables per second), and intonation (unitless).

  12. Affect Dimensions of Vocalized Emotional Expressions

    Time frame: Assessed weekly from week 1 to week 8, as part of the Dyad Voice Assessment (DYVA)

    Assessment of continuous affective dimensions of vocalized emotional expressions during participants' daily Dyad practice using audEERING devAIce software. The following parameters will be assessed: arousal, valence, and dominance (each ranging from -1 to 1). Based on arousal-valence scores, the following affect quadrant values will be calculated: high-arousal-high-valence, low-arousal-high-valence, low-arousal-low-valence, and high-arousal-low-valence.

  13. Affect Categories of Vocalized Emotional Expressions

    Time frame: Assessed weekly from week 1 to week 8, as part of the Dyad Voice Assessment (DYVA)

    Classification of vocalized emotional expressions into affect categories during participants' daily Dyad practice using audEERING devAIce software. The following categories will be assessed: angry, happy, and sad, expressed as unitless values ranging from 0 to 1 representing category likelihood.

  14. Stress intensity

    Time frame: Assessed using an EMA design with five push-notification measurements per day, distributed across five 3-hour intervals, on four days within a two-week period, at pre-test (Baseline) and after the 8-week intervention period (post-intervention).

    Custom items based on the Stress Appraisal Measure (SAM; Delahaye et al., 2015; Peacock & Wong, 1990) measuring stress intensity. Higher scores indicate more intense stress.

  15. Coping strategies

    Time frame: Assessed using an EMA design with five push-notification measurements per day, distributed across five 3-hour intervals, on four days within a two-week period, at pre-test (Baseline) and after the 8-week intervention period (post-intervention).

    Custom items based on the Brief-COPE (Carver, 1997; Knoll et al., 2005) and Cognitive Emotion Regulation Questionnaire (CERQ; Garnefski et al., 2001; Loch et al., 2011) measuring Coping Strategies (Acceptance, Positive Reinterpretation, Social Support, Rumination, Self-Blame, Distraction). Higher scores indicate a higher use of the specified coping strategies.

  16. Active Empathic Listening Scale (AELS)

    Time frame: Assessed at baseline (pre-test), after 4 weeks of empathic listening training (mid-intervention) and after the 4 weeks of compassionate listening training (post-test 1 & 2)

    A scale measuring active empathic listening (Bodie, 2011). Higher scores indicate more active empathic listening.

  17. Attachment behavior (ASQ)

    Time frame: Assessed at baseline (pre-test) and after the 8-week intervention period (post-test 1 & 2)

    A self-report questionnaire measuring attachment-related behaviors in interpersonal relationships, including proximity seeking, avoidance, and security (Hexel, 2004). Higher scores indicate more pronounced attachment-related behaviors.

Secondary outcomes

  1. Positive Affect (Affect Grid) (explanatory mechanism)

    Time frame: Assessed weekly during the course of 8 weeks of intervention

    Assessment of emotional state (valence) and arousal (Russell et al., 1989). Higher scores on valence and arousal indicate more positive affect and higher arousal.

  2. Emotion Acceptance (EAQ) (explanatory mechanism)

    Time frame: Assessed weekly during the course of 8 weeks

    A self-report questionnaire measuring emotional awareness, and acceptance of emotions (Beblo et al., 2011; Kisley et al., 2025). Higher scores indicate greater emotion awareness and acceptance

  3. Gratitude Questionnaire-6 (GQ-5-G) (explanatory mechanism)

    Time frame: Assessed weekly during the course of 8 weeks

    A scale measuring gratitude (Hudecek et al., 2021; McCullough et al., 2002). Higher scores indicate more gratitude.

  4. Self-Kindness Scale (SCS-SF) (explanatory mechanism)

    Time frame: Assessed weekly during the course of 8 weeks

    A self-report questionnaire measuring self-kindness and compassionate attitudes toward oneself (Hupfeld & Ruffieux, 2011; Raes et al., 2011). Higher scores indicate greater self-kindness.

  5. Positive Interpretation Bias (ERT) (explanatory mechanism)

    Time frame: Assessed at baseline (pre-test) and after the 8-week intervention period (post-test 1 & 2)

    This task assesses the tendency to judge persons' facial expressions more positively using morphed sequences of facial expressions (DeBruine & Jones, 2017; Griffiths et al., 2015). Higher scores indicate a stronger positive interpretation bias.

  6. Mentalizing (MENTS) Scale (explanatory mechanism)

    Time frame: Assessed weekly during the course of 8 weeks

    A self-report questionnaire measuring the capacity to understand one's own and others' mental states (Dimitrijević et al., 2018). Higher scores indicate greater mentalizing ability.

  7. Short Loneliness Scale (SLS) (explanatory mechanism)

    Time frame: Assessed weekly during the course of 8 weeks

    A short scale measuring frequency, intensity, and duration of loneliness (Hughes et al., 2004; Qualter et al., 2021). Higher scores indicate more loneliness.

  8. Perceived Stress (PSS-10) (explanatory mechanism)

    Time frame: Assessed weekly during the course of 8 weeks

    A self-report questionnaire measuring the degree to which situations in one's life are appraised as stressful (Cohen et al., 1983; Klein et al., 2016). Higher scores indicate greater perceived stress.

  9. Depression (PHQ-2) (explanatory mechanism)

    Time frame: Assessed weekly during the course of 8 weeks

    A brief self-report screening measure assessing core depressive symptoms, including depressed mood and anhedonia (Kroenke et al., 2003). Higher scores indicate greater depressive symptom severity.

  10. Empathic Concern & Distress (IRI) (explanatory mechanism)

    Time frame: Assessed weekly during the course of 8 weeks

    A scale measuring different facets of social emotions, including personal distress and empathic concern (Davis, 1980; Paulus, 2009). Higher scores indicate higher personal distress or empathic concern.

  11. Trust (KUSIV3) (explanatory mechanism)

    Time frame: Assessed weekly during the course of 8 weeks

    A self-report questionnaire measuring generalized interpersonal trust, including trust in others' reliability and integrity (Beierlein et al., 2012). Higher scores indicate greater interpersonal trust.

  12. In-group-Out-group bias (ERT) (explanatory mechanism)

    Time frame: Assessed at baseline (pre-test) and after the 8-week intervention period (post-test 1 & 2)

    This task assesses the tendency to judge persons from one's own group to be more positive in facial emotion recognition using morphed sequences of facial expressions (DeBruine & Jones, 2017; Griffiths et al., 2015). Higher scores indicate a stronger in-group-out-group bias.

  13. Coping strategies (explanatory mechanism)

    Time frame: Assessed weekly during the course of 8 weeks

    Custom items based on the Brief-COPE (Carver, 1997; Knoll et al., 2005) and Cognitive Emotion Regulation Questionnaire (CERQ; Garnefski et al., 2001; Loch et al., 2011) measuring Coping Strategies (Acceptance, Positive Reinterpretation, Social Support, Rumination, Self-Blame, Distraction). Higher scores indicate a higher use of the specified coping strategies.

  14. DPR-Affect (Affect Grid; explanatory mechanism)

    Time frame: Assessed for 8 weeks during intervention period, before the daily exercise

    Assessment of emotional state (valence) and arousal (Russell et al., 1989) just before starting the Dyad. Higher scores on valence and arousal indicate more positive affect and higher arousal.

  15. DPR-involvement (explanatory mechanism)

    Time frame: Assessed for 8 weeks during intervention period, only in the intervention group, after the daily exercise

    Assessment of listening involvement (1 custom item; only post-Dyad exercise). Higher scores indicate more listening involvement.

  16. Dyad closeness - Inclusion of Other in Self Scale (explanatory mechanism)

    Time frame: Assessed for 8 weeks during intervention period, only in the intervention group, after the daily exercise

    Assessment of how close participants felt to their Dyad partner (post-Dyad exercise). Higher scores indicate more closeness (Aron et al., 1992; Kinnunen & Windmann, 2013).

  17. Dyad listening quality (DPR- listening-quality)

    Time frame: Assessed weekly from week 1 to week 8, after the Dyad practice

    Custom items (self-generated) measuring the quality of listening to the Dyad partner. Higher scores indicate a higher degree of active, attentive listening

  18. DPR-Emotions

    Time frame: Assessed weekly from week 1 to week 8, as part of the Dyad Voice Assessment (DYVA)

    Emotion intensities (of e.g., happiness, gratitude, sadness, anger) rated by the speaker and by the listener of a Dyad directly after the Dyad.

  19. DPR-Listening-Affect

    Time frame: Assessed weekly from week 1 to week 8, after the Dyad practice

    Custom items (self-generated) measuring the self-rated affective state during listening to the Dyad partner's telling of the difficult situation and the event that they are grateful for. Higher scores indicate a more positive affect.

  20. Dyad empathic and compassionate listening skills (DPR-listening-skills)

    Time frame: Assessed weekly from week 1 to week 8, after the Dyad practice

    Custom items (self-generated) measuring the self-rated skill of listening empathically and compassionately to the Dyad partner's telling of the difficult situation and the event that they are grateful for. Higher scores indicate a higher degree of empathic or compassionate listening respectively.

Other outcomes

  1. Patient Health Questionnaire (PHQ-9; pre-screening)

    Time frame: Assessed before the intervention, only once, to pre-screen out from the study individuals who have clinical levels of depressive symptoms

    A scale assessing depression (Löwe et al., 2004; Martin et al., 2006). Higher scores indicate more depression.

  2. Generalized Anxiety Disorder (GAD-7; pre-screening)

    Time frame: Assessed prior to the intervention, only once, to pre-screen out from the study individuals who have clinical levels of anxious symptoms

    A scale assessing generalized anxiety (Spitzer et al., 2006; Löwe et al., 2007). Higher scores indicate more anxiety.

  3. Toronto Alexithymia Scale (TAS-20; pre-screening)

    Time frame: Assessed before the intervention, only once, to pre-screen out from the study individuals who have high levels of alexithymia

    A scale assessing alexithymia (Bagby et al., 1994; Ritz & Kannapin, 2000). Higher scores indicate more alexithymia.

  4. Standardized Assessment of Personality - Abbreviated Scale (SAPAS; pre-screening)

    Time frame: Assessed before the intervention, only once, to pre-screen out from the study individuals who have high levels of personality disorders symptoms

    A self-report scale used to screen personality disorders (Moran et al., 2003; Söchtig et al., 2012).

  5. General demographic questions

    Time frame: Assessed before the intervention, only once, to collect demographic information

    Self-generated demographic items.

Sponsors and collaborators

Lead sponsor

Max Planck Social Neuroscience Lab

Other

Collaborators

  • Paracelsus Medizinische Privatuniversität (PMU)

Registry information

Official study title

The Edu:Social Health Care Project: Investigating the Effects of an Online Socio-emotional Dyad Intervention on Healthcare Students' Mental Health, Resilience, Social Competencies and Behaviors

Acronym: EduSocHealth

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Feb 12, 2026
Registry last updated
May 19, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

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This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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