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Abstract

Objective

The increasing incidence of compassion fatigue and declining compassion satisfaction among helping professionals underscores the critical need for accessible and empirically supported interventions. Mobile applications represent a viable solution due to their broad accessibility, cost-effectiveness, and scalability.

Methods

The present study examined the effectiveness of the Emotion-Focused Training for Helping Professionals mobile application in targeting multiple dimensions of psychological well-being, including compassion fatigue, compassion satisfaction, resilience, compassion for others, compassion from others, self-compassion, and self-criticism. A total of 190 helping professionals from Slovakia participated in a 14-day intervention, with assessments administered at both baseline and postintervention.

Results

Despite the relatively brief intervention period, participants exhibited statistically significant improvements in compassion satisfaction, resilience, compassion for others, compassion from others, and self-compassion. Additionally, significant decreases were observed in levels of compassion fatigue and self-criticism. These findings provide preliminary support for the application's potential as an effective tool for enhancing psychological resilience and emotional well-being among helping professionals.

Conclusion

To improve the generalizability of these results, future research should examine the intervention's efficacy across culturally and linguistically diverse populations. Moreover, methodological robustness could be strengthened in subsequent studies through the inclusion of control groups and randomized controlled trial designs.

Keywords

Burnout compassion fatigue compassion satisfaction digital health mHealth eHealth mobile application occupational stress secondary traumatic stress

Introduction

Helping professionals are based on theoretical and empirical literature these individuals whose primary occupational roles involve providing care, support, or guidance aimed at promoting the well-being of others, whether in health, education, social care, or community contexts.^1–3 This group typically includes psychologists, social workers, nurses, physicians, counselors, and other mental health and human service providers.² In addition to traditional helping roles, our sample also included sports coaches, who can be conceptualized as helping professionals due to their engagement in relationship-oriented work that fosters motivation, emotional support, and personal development in others. As highlighted by reference,⁴ coaching involves the provision of social and emotional support and the cultivation of interpersonal relationships that contribute to the well-being and resilience of athletes. Accordingly, sports coaches were deemed consistent with the broader conceptualization of helping professionals adopted in this study.

This inclusive framework recognizes that the core professional function—offering empathic, relational, and emotional support—is shared by nurses, teachers, social workers, pharmacists, police officers, and other professionals whose work involves sustained emotional engagement with those they serve.⁵ Teachers and police officers, for instance, are frequently exposed to emotionally demanding interpersonal situations, secondary trauma, and the need for compassion regulation, paralleling the experiences of healthcare workers.⁶ Including these professions therefore provides a more ecologically valid understanding of compassion fatigue (CF) and resilience across diverse care- and service-oriented contexts.

The present study aimed to examine the transprofessional mechanisms of emotion regulation and self-compassion training that transcend specific occupational settings. This broader approach aligns with recent interdisciplinary research demonstrating that compassion-based interventions can enhance well-being across multiple helping professions.^7,8

Due to the emotionally intensive nature of their work, these professionals face an elevated risk of developing CF, with prevalence rates reported between 40% and 85%.⁹ This condition has been linked to a range of negative outcomes, including serious mental and physical health problems, decreased job performance, and significant economic burden.

The personal and professional consequences of CF are far-reaching. It can erode well-being, increase the likelihood of clinical errors, reduce patient satisfaction, and contribute to higher staff turnover and diminished overall performance.¹⁰ Affected individuals may experience emotional detachment, exhaustion, and lack of motivation, often accompanied by symptoms such as depression, anxiety, substance misuse, and even suicidal ideation.¹¹ Moreover, a recent systematic review and meta-analysis of 71 studies by Cavanagh et al.¹² indicates that CF can subtly impair the quality of care provided across healthcare settings. It has also been associated with compromised clinical judgment, leading to poor decision-making, misdiagnoses, and in some cases, mistreatment or abuse.¹³

One of the foundational scholars in this field, Figley,¹⁴ emphasized that the act of engaging empathetically with others’ suffering may lead to emotional exhaustion in the caregiver. In his framework, the term caregiver is used broadly to encompass both informal carers (such as family members and friends) and professional helpers including nurses, social workers, teachers, therapists, and other practitioners whose work requires sustained empathic engagement. In the present study, the term refers specifically to professional helping roles. As helping professionals strive to deeply understand and share in the emotional experiences of their clients, they can become vulnerable to emotional strain themselves. Compassion fatigue is thus conceptualized as a state of emotional and physical depletion that reduces the capacity to empathize or respond effectively to the distress of others.¹⁴ In contrast, compassion satisfaction (CS) refers to the positive emotional rewards derived from effectively helping others, such as feelings of accomplishment, meaning, and professional motivation.¹⁵ These opposing experiences are viewed as critical components of what Stamm¹⁵ calls professional quality of life, which encompasses both the positive dimension (CS) and the negative dimension (CF, comprising burnout [BO], and secondary traumatic stress). Further elaborating on this concept, Halamová et al.¹⁶ identified two core aspects of CS: Personal Integrity and Happiness and Work Competence and Happiness, representing the balance between one's sense of personal fulfillment and perceived professional efficacy. Including this distinction strengthens the theoretical understanding of how professionals derive meaning and satisfaction from their work and serves as a foundation for the current study.

Closely related to CS and fatigue is the concept of resilience. Resilience is generally defined as the capacity to maintain or restore psychological well-being when faced with adversity, stress, or trauma.¹⁷ It encompasses both enduring personal traits and flexible adaptive processes that support effective functioning in challenging circumstances.^18,19 Research indicates that resilience is influenced by a complex interplay of biological, psychological, genetic, and environmental factors.^20–23 Recent qualitative research has provided valuable insights into how helping professionals cultivate resilience in emotionally demanding work. These studies emphasize that resilience is not a fixed trait but a dynamic, learnable process supported by self-reflection, emotional regulation, and social connectedness.^24–27 Foster et al.²⁵ found that workplace resilience training strengthened nurses’ coping by promoting strategies such as positive self-talk, managing negative thoughts, regulating emotions, and detaching from stress, while Foureur et al.²⁶ demonstrated that mindfulness practice enhanced self-awareness and emotional balance among nurses and midwives. Together, these findings underscore that resilience in helping professions develops through adaptive coping, emotional awareness, and supportive professional relationships. Thus, fostering resilience may serve as a protective factor that not only buffers against CF but also enhances the capacity for CS.

Early recognition of CF allows professionals to develop coping strategies and prevent its progression.²⁸ This is especially important in settings where inadequate care can severely affect patients’ health.²⁹ In later stages, the level of CF could be mitigated by various psychological interventions. A recent systematic review and meta-analysis by Lipsa et al.³⁰ evaluated the effectiveness of psychological interventions in mitigating CF among helping professionals. Analyzing 82 studies and 11 randomized controlled trials (RCTs), the meta-analysis found that psychological interventions significantly reduced CF symptoms (SMD = −0.95; 95% CI [−1.63, −0.27]; p = 0.006). Online-delivered interventions showed greater effectiveness compared to in-person formats. Commonly applied approaches included mindfulness, psychoeducation, and resilience training. These findings underscore the potential of scalable, technology-assisted interventions in supporting the mental health and occupational functioning of professionals exposed to CF.

One psychological intervention that not only reduces CF but also increases CS—potentially benefiting both helping professionals and their patients—is Emotion-Focused Training for Helping Professionals (EFT-HP).^8,31 Both studies by Halamová et al.^8,31 assessed the effectiveness of EFT-HP in enhancing psychological well-being among helping professionals. Each utilized a RCT design with a 14-day asynchronous online intervention delivered via emails, though the studies differed in sample size and focus. The 2022 study (N = 253) found significant short- and long-term reductions in secondary traumatic stress, BO, and self-criticism, along with increases in self-compassion, with these effects sustained over two months. In contrast, the 2025 study (N = 667) broadened its focus by including CS, and observed significant improvements in self-compassion, self-reassurance, and CS. However, while changes in CF were noted in both groups, the between-group effects were limited. Despite this, both studies highlight the potential of EFT-HP in reducing self-criticism and fostering positive professional qualities, establishing it as a low-cost, scalable intervention to enhance the emotional resilience of helping professionals.

Building on the framework of an email-based intervention, developing a mobile application from an email-based intervention offers several benefits, including increased accessibility, user engagement, and sustained adherence.³² Mobile apps provide greater flexibility and convenience compared to email-based interventions, as users can access materials and support in real-time, regardless of location. Additionally, the interactive features of mobile apps—such as push notifications, reminders, and data tracking—help increase user engagement and motivation, which are crucial for sustained intervention success. Personalization of content based on user preferences and behaviors further enhances effectiveness. Moreover, mobile apps enable continuous data collection, which allows for real-time monitoring of progress and facilitates timely intervention adjustments.³³ Finally, mobile apps are highly scalable, providing an efficient means of delivering interventions to a large number of users and ensuring easy updates to content, which is difficult to achieve with static email-based interventions.³⁴ Beyond interventions for CF, research on mobile health (mHealth) technologies highlights their general strengths in improving access, engagement, and adherence across diverse health domains. A scoping review³⁵ demonstrated that mHealth interventions enhance communication, facilitate ongoing support, and empower users to sustain health-related behaviors. These advantages underscore the potential of mHealth-based psychological interventions, such as EFT-HP, to promote resilience and well-being in helping professionals.

The research aim

This study evaluated the effectiveness of the mobile application format of the newly developed EFT-HP^8,31 in addressing CF, CS, resilience, compassion for others, compassion from others, self-compassion, and self-criticism. It was hypothesized that, relative to the pretest assessment, the participants would exhibit a statistically significant reduction in CF and self-criticism, alongside a significant increase in CS, resilience, compassion for others, compassion from others, and self-compassion at both the posttest assessment.

Methods

The research sample

Participants were recruited through an online survey distributed via social media platforms (e.g., Facebook, Instagram, and Reddit) and through professional networks of helping professions, using a snowball sampling method. This recruitment strategy allowed the inclusion of a broad spectrum of professionals whose work involves providing care, education, protection, or support to others—consistent with established definitions of helping professionals.²

This study employed a single-group pre–post quasi-experimental design aimed at evaluating the short-term effects of the EFT-HP mobile application. Data collection was conducted online in the Slovak Republic between 1 January 2025 and 15 March 2025. Participants completed all study procedures remotely through the Self-Growth Institute platform (www.self-growth-institute.com).

Although the study employed a single-group pre–post design without a comparator, this approach is commonly used in early-stage feasibility and proof-of-concept studies to evaluate preliminary efficacy and acceptability before proceeding to RCTs.^36,37 The design was therefore chosen to assess within-subject changes and to identify meaningful short-term trends associated with exposure to the EFT-HP intervention.^8,31 While causal inferences cannot be drawn from this design, it provides valuable groundwork for future controlled studies to establish efficacy and generalizability.

The data collection process adhered to the ethical standards outlined in the 1964 Declaration of Helsinki and its subsequent amendments. The study's protocol was approved by the Ethical committee of Faculty of Social and Economic Sciences at Comenius University Bratislava FSEV 1647/-4/2022/SD-CIII/1. All participants provided electronic informed consent before taking part in the study. The final sample consisted of 190 helping professionals who completed both pre- and postintervention assessments. Of these, 64 identified as male (33.7%) and 125 as female (65.8%), and one person preferred not to disclose gender. The mean age of participants was 37.76 years (SD = 10.04). The professional distribution included nurses (20%, n = 38), teachers (18.9%, n = 36), social workers (15.3%, n = 29), pharmacists (14.7%, n = 28), police officers (13.2%, n = 25), veterinarians (8.9%, n = 17), sports coaches (3.7%, n = 7), home care assistants (3.2%, n = 6), psychotherapists (1.1%, n = 2), one lawyer (0.5%), and one radiologist (0.5%). The majority of participants were Slovak nationals, with only four individuals identifying otherwise. No missing data were present in the dataset, as the questionnaire required responses to all items before participants could proceed.

Inclusion criteria required participants to (a) be 18 years of age or older, (b) currently work in a helping profession—defined as an occupation in which the primary role involves providing care, support, education, guidance, or protection to promote others’ well-being and (c) have sufficient Slovak language proficiency to complete the intervention and self-report measures. Exclusion criteria included individuals under 18 years of age, those not currently employed in a helping profession, and duplicate survey responses.

Power analysis

A power analysis was conducted to determine the appropriate sample size for detecting a medium effect. To identify an effect size of dz = 0.5 with a significance level of α = 0.05 and statistical power of 80% (1–β = 0.80), a minimum of 28 participants was required. This number refers to the total sample, not divided into separate groups.

Given the within-subjects design of the study, the Wilcoxon signed-rank test for paired samples was used to assess changes in participants’ scores before and after the intervention. This nonparametric test was chosen due to the ordinal nature of the data and potential deviations from normality.

A one-tailed test was applied based on the directional hypothesis that participants would show improvement following the intervention. Therefore, statistical significance was assessed only in the expected direction. Any change in the opposite direction (i.e., deterioration) would not be identified as statistically significant.

With a sample size of 28 participants, the actual power of the test was estimated at 80.83%, indicating a strong likelihood of detecting a true effect of medium size, should it exist.

The research instruments

Given the exploratory nature of the study, multiple psychometrically robust instruments were used to capture complementary aspects of professional quality of life, compassion, CS, CF, self-criticism, and resilience. Using multiple validated measures enabled a more comprehensive understanding of how different, yet related, emotional and cognitive processes might change in response to the intervention.^38,39 Although the number of measures increased assessment load, all scales were brief, reliable, and relevant to the constructs targeted by EFT-HP. The average completion time for the pre- and postassessments was under 25 min, consistent with participant burden guidelines for online psychological research.⁴⁰

The short professional quality of life scale.⁴¹

The Professional Quality of Life (ProQOL; 15) scale is one of the most widely used instruments in applied healthcare research for assessing BO, CF, and CS. The original version of ProQOL consists of 30 items, while the Short ProQOL was condensed into the nine-item version which demonstrated a sound internal structure and cross-national measurement invariance, confirmed the scale's structural validity and reliability and it showed meaningful associations with measures of coping with death, self-compassion, and self-care. The reliability coefficients of the Short ProQOL varied from 0.82 to 0.84.

The Compassion Satisfaction and Compassion Fatigue Scale.¹⁶

The Compassion Satisfaction and Compassion Fatigue Scale (CSCFS) was developed by shortening the original Compassion Satisfaction/Fatigue Self-Test for Helpers⁴² by applying a Mokken scale analysis for polytomous items. The CSCFS consists of five items for the Compassion Satisfaction—Personal Integrity and Happiness subscale, five items for the Compassion Satisfaction—Work Competence and Happiness subscale, nine items for the Compassion Fatigue—Secondary Traumatic Stress subscale, and seven for the Compassion Fatigue—Burnout subscale. The reliability coefficients of the CSCFS varied from 0.75 to 0.87.

The Forms of Self-Criticism and Self-Reassurance Scale.⁴³

The Forms of Self-Criticism and Self-Reassurance Scale (FSCRS) is a 22-item self-report measure designed to evaluate how individuals relate to themselves in times of difficulty. The scale comprises three distinct subscales: Inadequate Self (IS), which captures feelings of personal failure and perceived shortcomings; Hated Self (HS), reflecting self-directed anger or a desire for self-punishment; and Reassured Self (RS), which assesses the individual's capacity for self-compassion and emotional support for self. A global measure of self-criticism can be derived by combining scores from the IS and HS subscales. The FSCRS has demonstrated strong internal consistency, with reliability coefficients ranging from 0.90 to 0.95, and its factor structure has been validated across various cultural contexts.⁴⁴

The Sussex-Oxford Compassion Scales for Self⁴⁵ and for Others⁴⁵ and From Others.⁴⁶

The Sussex-Oxford Compassion Scale for Compassion from Others was created by adapting items from the original Sussex-Oxford Compassion Scales for Self (SOCS-S; 45) and for Others (SOCS-O; 45) adjusting the item wording to reflect the direction of compassion from others to oneself. All scales SOCS-S, SOCS-O, and Sussex-Oxford Compassion Scales From Others (SOCS-FO) include 20 items across five subscales: recognizing suffering, understanding suffering's universality, empathic concern, tolerating discomfort, and motivation to alleviate suffering. The reliability coefficients of the CSCFS varied from 0.69 to 0.93 for SOCS-S and SOCS-O in Slovak translation⁴⁷ and for SOCS-FO between 0.82 and 0.98.⁴⁶

The 10-item Connor–Davidson Resilience Scale.⁴⁸

The 10-item Connor–Davidson Resilience Scale (CD-RISC-10) assesses how frequently individuals demonstrate resilience-related behaviors and attitudes. Total scores range from 0 to 40, with higher scores reflecting greater resilience. This measure is commonly employed in resilience research due to its demonstrated reliability and validity across various populations, including various cultures and language translations.⁴⁹ The scale was translated in Slovak language by Tavel et al.⁵⁰ The CD-RISC-10 demonstrated strong internal consistency, with a Cronbach's alpha coefficient of 0.873 based on the meta-analysis of Wojujutari et al.⁴⁹ In the present study, the total score was used for analysis.

Research procedure

Participants downloaded the mobile application form the Self-growth Institute webpage, where are several available mental health trainings for free (www.self-growth-institute.com). Participants completed the pretest, daily exercises over a 14-day period, and posttest. Each day, participants were able to open and complete one exercise involved in the day's task, which included the explanation of the task's purpose together with related psychoeducational content, and detailed instructions for implementation. To encourage active engagement and monitor adherence, participants were asked to submit a brief reflection after completing each exercise every day. These reflections addressed emotional, cognitive, and behavioral responses to the daily task. Due to technical difficulties, no reminders were sent to participants who had not yet completed their daily task to support compliance with the intervention timeline.

Research intervention

The EFT-HP intervention^8,31 was created by professor Júlia Halamová based on her extensive research on effectiveness of various interventions and psychotherapeutic experience in Emotion-focused therapy^51,52 and Somatic Trauma Therapy.⁵³ The EFT-HP exercises address a range of relevant topics, including CF, compassion, self-compassion, self-criticism, self-protection, self-care, professional mission, mindfulness, work–life balance, savoring, and the strengthening of trauma protection skills critical for helping professionals. The intervention³¹ consisted of the following daily tasks inspired by previous works:

1st day: What are my signs of CF?⁵⁴

2nd day: How would I take care of my client/patient?⁵⁵

3rd day: What does the great supervisor want to share with me?⁵⁶

4th day: How can I calm myself through mindfulness?⁵⁷

5th day: How do I sabotage myself?⁵³

6th day: How can I be compassionate toward myself?⁵⁷

7th day: How can I stand up for myself?⁵⁷

8th day: How can I let go of the things I can’t control?⁵⁵

9th day: Reminder of my mission^2,56

10th day: How to regulate through nonmirroring?⁵³

11th day: How can I protect myself against CF?⁵³

12th day: How can I separate work from personal life?⁵³

13th day: How can I savor the moment?⁵⁸

14th day: What is my personal/work life balance?⁵⁹

Mobile application usage protocol

Participants accessed the EFT-HP mobile application by visiting https://www.self-growth-institute.com/ and downloading the application to their mobile devices. The 14-day intervention protocol required participants to complete daily exercises lasting approximately 15 min each. The recommended usage frequency was at least once daily, with participants expected to complete a minimum of 12 out of 14 exercises over the intervention period to be included in the final analysis. The application did not include automated reminder notifications; participants were responsible for self-directed engagement with the daily exercises. Usage monitoring was implemented through structured reflections entries that participants completed after each exercise session. These reflections served both as a monitoring tool and as an integral part of the therapeutic process, encouraging participants to process their emotional experiences and insights gained from each session. Technical support was available throughout the intervention period via email contact with the research team.

Data analysis

Data were processed in Excel and subsequently analyzed using the R statistical software.⁶⁰ We used the nparLD package for nonparametric analysis of longitudinal data in factorial experiments.^61,62 Statistical analyses were conducted to examine changes between pre- and postintervention measurements in CS, CF, self-criticism, compassion to others, compassion from others, and self-compassion. We tested for a significant interaction effect between time points and assessed changes by examining the overlap (or lack thereof) in the confidence intervals. Specifically, we considered intervals nonoverlapping when the upper bound of Time 1 was lower than the lower bound of Time 2, or vice versa. We will present the relative treatment effects (RTE) with their confidence intervals. The RTE are probabilistic measures of effect sizes. The RTEs express the probability that the value from a group in question will be higher (or lower) than randomly selected value from the sample.⁶¹ Values below 0.5 indicate decreases (desirable for negative outcomes), while values above 0.5 indicate increases (desirable for positive outcomes).

Results

Overall pattern of change

The intervention demonstrated a highly consistent and comprehensive pattern of positive psychological change across multiple domains. Participants showed significant improvements in all prosocial factors (CS, resilience, and various forms of compassion) while simultaneously experiencing substantial reductions in all maladaptive factors (CF, BO, and self-criticism). This bidirectional pattern suggests the intervention's potential for both enhancing protective factors and reducing risk factors associated with professional BO.

The magnitude of changes varied systematically across domains, with self-compassion showing the most substantial improvements (RTE values of 0.68–0.89), followed by perceived compassion from others (RTE values of 0.80–0.87) and resilience (RTE = 0.77). Compassion toward others showed moderate to large improvements (RTE values of 0.61–0.78), while professional quality of life measures demonstrated large decreases in negative dimensions (BO RTE = 0.27, CF RTE = 0.29) and moderate increases in positive dimensions (CS RTE = 0.65).

Notably, self-criticism showed particularly strong reductions, with feelings of inadequacy demonstrating the largest single effect size observed in the study (RTE = 0.17), while self-reassurance increased substantially (RTE = 0.74). All changes were in the predicted direction based on emotion-focused therapy principles, supporting the intervention's theoretical foundation.

Interrelationship among measures

The observed changes across measures revealed theoretically coherent patterns that illuminate potential mechanisms of change. The substantial improvements in self-compassion (F = 124.45, RTE values 0.68–0.89) appeared to serve as a foundation for improvements in other domains, suggesting this may be the primary mechanism through which the intervention achieves its effects.

The bidirectional relationship between self-criticism and self-compassion was particularly pronounced, with very large decreases in inadequate self (RTE = 0.17) and large increases in multiple self-compassion dimensions. This pattern aligns with emotion-focused therapy principles emphasizing the replacement of self-attacking with self-soothing internal dialogs.

An unexpected but theoretically important finding was the substantial improvement in perceived compassion from others (F = 78.32, all RTE values > 0.80). This suggests that enhanced self-compassion may increase individuals’ capacity to recognize, receive, and potentially elicit compassionate responses from their social environment, indicating secondary interpersonal benefits beyond direct intrapersonal change.

The concurrent improvements in professional quality of life measures—with large decreases in both BO (RTE = 0.27) and CF (RTE = 0.29) alongside moderate increases in CS (RTE = 0.65)—demonstrate the intervention's relevance to core concerns of helping professionals. The substantial increase in resilience (RTE = 0.77) further supports the intervention's capacity to enhance psychological resources for managing professional challenges.

Clinical significance of changes

Beyond statistical significance, the magnitude of changes indicates substantial practical importance for helping professionals across multiple domains of psychological well-being. Effect sizes ranged from moderate (RTE = 0.61) to very large (RTE = 0.89), with the most substantial improvements observed in self-compassion and the largest single effect being the reduction in inadequate self-criticism.

Self-Compassion Domain: The very large effect sizes for four of five self-compassion subscales (RTE values of 0.87–0.89) represent profound changes in participants’ ability to treat themselves with kindness during difficult times. These improvements exceed established benchmarks for meaningful psychological change and suggest that self-compassion training may be a particularly potent component for helping professionals.

Professional Resilience: The large increase in resilience (RTE = 0.77) indicates approximately a 77% probability that postintervention scores would exceed baseline levels. This represents clinically meaningful enhancement in participants’ capacity to cope with stress and adversity, potentially reducing vulnerability to future BO.

Reduction of Professional Distress: The large effect sizes for reductions in BO (RTE = 0.27) and CF (RTE = 0.29, 0.25, 0.20) represent meaningful decreases in symptoms that have been linked to compromised patient care, increased turnover, and personal distress. The very large reduction in inadequate self-criticism (RTE = 0.17) addresses a core vulnerability factor underlying professional BO.

Interpersonal Enhancement: The very large improvements in perceived compassion from others (RTE values 0.80–0.87) suggest meaningful changes in social connection and support recognition, which are crucial protective factors for helping professionals working in emotionally demanding environments.

Sustained Compassion Capacity: The moderate to large improvements in compassion toward others (RTE values 0.61–0.78) indicate enhanced capacity for empathic responding without the typical cost of emotional depletion. The particularly strong improvement in tolerating uncomfortable feelings (RTE = 0.78) may be crucial for preventing CF, as this skill allows professionals to remain emotionally present without becoming overwhelmed.

The comprehensive nature of these changes—spanning intrapersonal, interpersonal, and professional domains—suggests that the 14-day intervention produced meaningful shifts across the full spectrum of factors relevant to helping professional well-being.

Detailed statistical results

Regarding professional quality of life, as measured by the Short ProQOL,⁴¹ we found significant differences between pre- and postintervention time points after using the mobile application EFT-HP, with a significant difference found using ANOVA-type statistics F_{(1, ∞)} = 24.15, p < 0.001. The BO subscale showed a large decrease (RTE = 0.27), with nonoverlapping confidence intervals: Time 1 (95% CI = 0.48–0.54) and Time 2 (95% CI = 0.35–0.40). Similarly, the Compassion Fatigue subscale demonstrated a large decrease (RTE = 0.29), with Time 1 (95% CI = 0.38–0.43) and Time 2 (95% CI = 0.27–0.32). In contrast, Compassion Satisfaction showed a moderate increase (RTE = 0.65), with Time 1 (95% CI = 0.63–0.70) and Time 2 (95% CI = 0.72–0.77) (see Figure 1).

Figure 1.

Change in professional quality of life scores of the short ProQOL between pre- and postmeasurements following participation in the mobile application intervention EFT-HP.⁴¹

Regarding CS and CF, as assessed by the CSCFS,¹⁶ significant differences were found between pre- and postintervention time points after using the mobile application EFT-HP, with a significant difference found using ANOVA-type statistics F_{(1, ∞)} = 43.72, p < 0.001. The Compassion Fatigue Burnout subscale showed a large decrease (RTE = 0.25), with nonoverlapping confidence intervals: Time 1 (95% CI = 0.50–0.58) and Time 2 (95% CI = 0.29–0.35). Similarly, the Compassion Fatigue Secondary Traumatic Stress subscale demonstrated a large decrease (RTE = 0.20), with Time 1 (95% CI = 0.57–0.65) and Time 2 (95% CI = 0.37–0.46). The Compassion Satisfaction Personal Integrity and Happiness subscale showed a moderate increase (RTE = 0.65), with nonoverlapping confidence intervals: Time 1 (95% CI = 0.45–0.52) and Time 2 (95% CI = 0.53–0.60). The Compassion Satisfaction Work Competence and Happiness subscale showed a small, nonsignificant change (RTE = 0.55), with overlapping confidence intervals: Time 1 (95% CI = 0.47–0.54) and Time 2 (95% CI = 0.53–0.59) (see Figure 2).

Figure 2.

Change in compassion satisfaction and compassion fatigue scores of the CSCFS between pre- and postmeasurements following participation in the mobile application intervention EFT-HP.

Regarding resilience, as measured by the CD-RISC-10,⁴⁸ we observed a significant difference between pre- and postintervention time points after using the mobile application EFT-HP, with a significant difference found using ANOVA-type statistics F_{(1, ∞)} = 64.69, p < 0.001. Resilience showed a large increase (RTE = 0.77), with nonoverlapping confidence intervals: Time 1 (95% CI = 0.40–0.44) and Time 2 (95% CI = 0.56–0.60) (see Figure 3).

Figure 3.

Change in resilience scores of the CD-RISC-10 between pre- and postmeasurements following participation in the mobile application intervention EFT-HP.

In relation to self-criticism and self-reassurance, as measured by the FSCRS,⁴³ significant changes were observed between pre- and postintervention time points after the use of the mobile application EFT-HP, with a significant difference found using ANOVA-type statistics F_{(1, ∞)} = 41.58, p < 0.001. The Hated Self subscale showed a large decrease (RTE = 0.27), with nonoverlapping confidence intervals: Time 1 (95% CI = 0.27–0.30) and Time 2 (95% CI = 0.20–0.23), indicating a significant reduction in this severe form of self-criticism. The Inadequate Self subscale demonstrated a very large decrease (RTE = 0.17), with Time 1 (95% CI = 0.55–0.62) and Time 2 (95% CI = 0.41–0.45), suggesting substantial decline in feelings of inadequacy. Conversely, the Reassured Self subscale showed a large increase (RTE = 0.74), with nonoverlapping confidence intervals: Time 1 (95% CI = 0.67–0.73) and Time 2 (95% CI = 0.77–0.80), reflecting enhanced self-reassurance following participation in EFT-HP (see Figure 4).

Figure 4.

Change in self-criticism and self-reassurance scores of the FSCRS between pre- and postmeasurements following participation in the mobile application intervention EFT-HP.

With regard to self-compassion, assessed using the SOCS-S,⁴⁵ significant differences were found between pre- and postintervention measurements following the use of the EFT-HP mobile application, with a significant difference found using ANOVA-type statistics F_{(1, ∞)} = 124.45, p < 0.001. All five subscales showed significant improvement, as indicated by nonoverlapping confidence intervals. The subscales demonstrated large to very large effect sizes: Recognising Suffering showed a very large increase (RTE = 0.88) from Time 1 (95% CI = 0.41–0.46) to Time 2 (95% CI = 0.58–0.62). Understanding the Universality of Suffering showed a large increase (RTE = 0.68) from Time 1 (95% CI = 0.49–0.55) to Time 2 (95% CI = 0.58–0.63). Feeling for the Person Suffering demonstrated a very large increase (RTE = 0.87) from Time 1 (95% CI = 0.35–0.39) to Time 2 (95% CI = 0.56–0.61). Tolerating Uncomfortable Feelings showed a very large increase (RTE = 0.88) from Time 1 (95% CI = 0.34–0.38) to Time 2 (95% CI = 0.53–0.58). Acting to Alleviate Suffering demonstrated a very large increase (RTE = 0.89) from Time 1 (95% CI = 0.38–0.42) to Time 2 (95% CI = 0.55–0.59). These results indicate significant overall enhancement in self-compassion across all dimensions following participation in the EFT-HP intervention (see Figure 5).

Figure 5.

Change in self-compassion scores of the SOCS-S between pre- and postmeasurements following participation in the mobile application intervention EFT-HP.

In relation to compassion toward others, as assessed by the SOCS-O,⁴⁵ significant differences were found between pre- and postintervention measurements after using the EFT-HP mobile application, with a significant difference found using ANOVA-type statistics F_{(1, ∞)} = 26.59, p < 0.001. All five subscales showed notable improvements, with confidence intervals not overlapping. The subscales demonstrated varying effect sizes: Recognising Suffering showed a large increase (RTE = 0.72) from Time 1 (95% CI = 0.42–0.47) to Time 2 (95% CI = 0.52–0.56). Understanding the Universality of Suffering showed a moderate increase (RTE = 0.61) from Time 1 (95% CI = 0.48–0.53) to Time 2 (95% CI = 0.54–0.59). Feeling for the Person Suffering demonstrated a large increase (RTE = 0.75) from Time 1 (95% CI = 0.44–0.48) to Time 2 (95% CI = 0.51–0.56). Tolerating Uncomfortable Feelings showed the largest improvement (RTE = 0.78) from Time 1 (95% CI = 0.39–0.43) to Time 2 (95% CI = 0.51–0.56). Acting to Alleviate Suffering showed a moderate increase (RTE = 0.66) from Time 1 (95% CI = 0.45–0.50) to Time 2 (95% CI = 0.51–0.56). These results indicate significant overall enhancement in compassion toward others across all dimensions following participation in the EFT-HP intervention (see Figure 6).

Figure 6.

Change in compassion for others scores of the SOCS-O between pre- and postmeasurements following participation in the mobile application intervention EFT-HP.

Regarding compassion from others, as measured by the SOCS-FO,⁴⁶ significant differences were observed between pre- and postintervention measurements following the use of the EFT-HP mobile application, with a significant difference found using ANOVA-type statistics F_{(1, ∞)} = 78.32, p < 0.001. All five subscales showed significant improvement, as indicated by nonoverlapping confidence intervals. The subscales demonstrated large to very large effect sizes: Recognising Suffering showed a very large increase (RTE = 0.81) from Time 1 (95% CI = 0.40–0.45) to Time 2 (95% CI = 0.53–0.58). Understanding the Universality of Suffering showed a very large increase (RTE = 0.86) from Time 1 (95% CI = 0.43–0.48) to Time 2 (95% CI = 0.58–0.62). Feeling for the Person Suffering demonstrated a very large increase (RTE = 0.87) from Time 1 (95% CI = 0.39–0.43) to Time 2 (95% CI = 0.55–0.60). Tolerating Uncomfortable Feelings showed a very large increase (RTE = 0.80) from Time 1 (95% CI = 0.40–0.45) to Time 2 (95% CI = 0.54–0.58). Acting to Alleviate Suffering demonstrated a very large increase (RTE = 0.85) from Time 1 (95% CI = 0.39–0.43) to Time 2 (95% CI = 0.56–0.60). These findings suggest significant overall increase in perceived compassion from others across all dimensions following participation in the EFT-HP intervention (see Figure 7).

Figure 7.

Change in compassion from others scores of the SOCS-FO between pre- and post-measurements following participation in the mobile application intervention EFT-HP.

Discussion

This study examined how the mobile application version of the recently developed EFT-HP^8,31 influences outcomes such as CF, CS, resilience, compassion directed toward and received from others, self-compassion, and self-criticism. The results of the current study strongly suggest that the EFT-HP delivered via a mobile application effectively enhances several key indicators of psychological well-being and professional functioning among helping professionals. The accessibility of the mobile format also holds promise for real-time, on-demand use in daily professional life. Such immediate availability may enable helping professionals to apply emotion-regulation and self-compassion strategies at the moment of need, potentially exerting a preventative effect on the development of CF and BO.^63,64

The significant reductions in BO and CF, alongside increased CS as measured by both the Short ProQOL⁴¹ and the CSCFS,¹⁶ align with prior research emphasizing the protective effects of compassion-based and resilience-building interventions in emotionally demanding helping professions.^14,15 These improvements are particularly important given the high prevalence of CF and BO in the helping professions, which are known to impair judgment, increase turnover, and negatively affect client care.^10,12

In addition, we evaluated the impact of the EFT-HP intervention on CS and CF using the CSCFS (16). In this case, comparing our results with available normative data was both more straightforward and more directly relevant, as the CSCFS provides percentilized norms specifically for helping professionals across all subscales. This allows for a clinically meaningful interpretation of score changes beyond statistical significance. Our participants showed substantial reductions in both Compassion Fatigue—Burnout and Compassion Fatigue—secondary traumatic stress following the intervention. Specifically, the mean score on the Compassion Fatigue—Burnout subscale decreased from 17.72 (corresponding to the 85th percentile) before the intervention to 11.43 (53rd percentile) after the intervention. Similarly, on the Compassion Fatigue—Secondary Traumatic Stress subscale, the mean score decreased from 19.97 (89th percentile) to 13.30 (75th percentile). These shifts reflect a clinically significant reduction in negative emotional outcomes, suggesting that participants experienced a noticeable alleviation of stress-related symptoms and emotional exhaustion.

The significant enhancement in resilience scores observed through the CD-RISC-10⁴⁸ further supports the growing body of literature recognizing resilience as a dynamic trait that can be cultivated through targeted psychological interventions.^65,66

Crucially, this study also demonstrated notable reductions in self-criticism and increases in self-reassurance, suggesting improved relationship toward self and enhanced internal coping and regulations strategies⁴³ an essential outcome for professionals regularly exposed to secondary trauma.

Ismail et al.⁶⁷ reviewed several studies involving various helping professionals and reported that the average total score on the CD-RISC-10⁴⁸ typically hovers around 30 out of a maximum of 40, indicating a moderate level of resilience. In our current study, participants achieved a mean score of 30.24 following the EFT-HP intervention, compared to a preintervention mean of 25.37. Ye et al.⁶⁸ examined parents of children with cancer and identified a cutoff score of 25.5 as indicative of low resilience. While direct comparisons across different helping populations should be made with caution, these findings can be meaningfully extended to helping professionals in high-stress caregiving roles. Based on this reference point, our sample of diverse helping professionals demonstrated an increase in resilience from a low to a moderate level which is a notable improvement in resilience among helping professionals following participation in the EFT-HP intervention. Our findings underscore the potential of EFT-HP to strengthen psychological resilience among helping professionals, a group that is frequently exposed to chronic emotional and occupational stressors. Enhancing resilience through accessible interventions such as EFT-HP could help mitigate the risk of CF and BO and ultimately contribute to the sustainability of helping professionals in emotionally demanding roles.

The observed increases in self-compassion and compassion toward others, as measured by the SOCS-S and SOCS-O,⁴⁵ reinforce the theoretical model that self-compassion not only buffers the impact of stress but also enhances empathetic engagement with others.⁶⁹ In addition, gains in perceived compassion from others (SOCS-FO; 46) underscore the reciprocal nature of compassion, whereby a professional's perception of social support plays a mediating role in mitigating BO.⁷⁰

At the same time, there were meaningful increases in both dimensions of CS. On the Compassion Satisfaction—Personal Integrity and Happiness subscale, the mean score increased from 16.65 (27th percentile) to 18.61 (42nd percentile). Likewise, the Compassion Satisfaction—Work Competence and Happiness subscale increased from 17.21 (40th percentile) to 18.40 (50th percentile). While these increases were more modest in absolute terms, they represent a positive psychological shift toward greater job-related fulfillment and personal integrity in caregiving roles. These findings are consistent with prior research showing that interventions targeting resilience can enhance professional quality of life among helping professionals because resilience was shown to be the key variable impacting level of CS.⁷¹ Given the demanding nature of helping roles and the high prevalence of CF in these populations,⁹ even moderate improvements in CS and reductions in fatigue can have significant implications for both individual well-being and the quality of care delivered. The results of our study therefore provide encouraging support for the utility of the EFT-HP intervention as a feasible and effective approach to fostering resilience and professional satisfaction among helping professionals.

The Compassion Satisfaction-Work Competence and Happiness subscale of the CSCFS¹⁶ showed only minimal overlap in confidence intervals, suggesting a trend toward improvement in this aspect of CS following the EFT-HP intervention. With a larger sample, this effect would likely reach statistical significance. Enhancing Compassion Satisfaction—Work Competence and Happiness may be more feasible through a mobile app intervention used individually by employees, compared to increasing Compassion Satisfaction—Personal Integrity and Happiness. We propose that the Work Competence and Happiness component is more strongly influenced by perceived organizational support, making it more amenable to change when the EFT-HP intervention is implemented at the team or organizational level.

This aligns with findings by Liu et al.,⁷² who reported that insufficient organizational support had a significant and direct impact on the development of CF among helping professionals. Conversely, Allen⁷³ identified a negative relationship between CS and a lack of organizational support. These findings underscore the importance of managerial involvement in supporting both the professional and psychological well-being of helping professionals, especially in high-stress environments. Enhancing perceived organizational support can help maintain psychological resilience, reduce CF, increase CS, and ultimately improve the quality of care provided.⁷⁴

Theoretical implications and mechanisms of change

These findings provide compelling support for emotion-focused therapy principles^51,52 when delivered through mobile technology. The hierarchical pattern of effect sizes—with self-compassion showing the largest improvements, followed by interpersonal compassion recognition, then professional resilience—suggests a developmental sequence consistent with EFT theory, where enhanced emotional processing capacity creates conditions for improved interpersonal and professional functioning.⁸⁰ This pattern aligns with meta-analytic evidence demonstrating that self-compassion serves as a protective factor against various forms of psychopathology, including those prevalent among helping professionals.^80,81

The intervention appears to have successfully targeted the fundamental emotional processing difficulties that underlie professional BO by enhancing participants’ capacity for emotional awareness, acceptance, and self-soothing. The substantial reduction in inadequate self-criticism (largest single effect in the study) may be particularly important, as harsh self-evaluation has been identified as a core vulnerability factor underlying the emotional dysregulation that leads to professional BO among healthcare workers.⁷⁰ The concurrent large increase in self-reassurance suggests participants developed stronger internal resources for emotional regulation during challenging professional situations, consistent with neurobiological research demonstrating distinct neural pathways for self-criticism versus self-reassurance.⁸²

The unexpected finding that self-compassion training enhanced perceived compassion from others warrants particular theoretical consideration, as this represents an important extension beyond previous research focusing primarily on intrapersonal effects. This may reflect improved emotional awareness that allows better recognition of supportive gestures, reduced defensive barriers to receiving help, or potentially even improved interpersonal behaviors that elicit more compassionate responses from colleagues and supervisors.⁸³ Such interpersonal benefits may be especially crucial for helping professionals, who often work in emotionally demanding environments where social support serves as a critical protective factor against CF.⁸⁴

From a mHealth perspective, these findings demonstrate that brief, self-directed digital interventions can produce meaningful psychological change when grounded in established therapeutic principles, consistent with recent meta-analytic evidence supporting the efficacy of smartphone-based mental health interventions.⁶³ The 14-day time frame suggests that fundamental shifts in emotional processing patterns may occur more rapidly than previously assumed, though the mechanisms underlying such rapid change warrant further investigation. The comprehensive nature of improvements across intrapersonal, interpersonal, and professional domains indicates that emotion-focused interventions may address multiple vulnerability factors simultaneously, offering particular promise for preventing and treating CF among helping professionals.⁸⁵

Implications

The demonstrated effectiveness of EFT-HP in reducing CF and enhancing resilience and self-compassion suggests that it can be integrated into workplace mental health strategies for various helping professionals, particularly in high-stress environments such as healthcare or education. The mobile format offers a scalable solution that overcomes common barriers to intervention access, such as geographical limitations, stigma associated with mental health support, time constraints, and lack of institutional support for in-person training.^63,64 Importantly, the flexibility of the app allows it to function both as a preventive self-care tool used regularly to maintain emotional balance and as a support resource during acute stress episodes. Future research should empirically examine which mode of use yields greater benefits for CF and CS. Given its asynchronous and self-guided nature, the app-based version of EFT-HP may provide a cost-effective alternative to traditional interventions, reducing the need for professionally led individual or group therapeutical sessions or trainings.⁷⁵ The study addresses a key gap in the digital mental health field by providing empirical evidence for an intervention that is both theoretically grounded and technologically accessible, contributing to the growing body of research supporting mHealth applications. In addition, the EFT-HP aligns with calls to strengthen the scientific basis for mHealth applications.³³ Therefore, the promising outcomes of this mobile-based intervention suggest that EFT-HP may serve as a low-cost, widely accessible, and sustainable tool for preventing CF and promoting CS and resilience in the helping professions.

Limitations and future directions

A key limitation of many mental health apps is the limited scientific evidence supporting their effectiveness.³³ Despite often being based on established frameworks such as some kind of therapy, only a few have undergone rigorous testing. A review by Donker et al.⁷⁵ identified just five scientifically supported apps, most of which required professional involvement, and none were publicly available on major app platforms. In contrast, the EFT-HP intervention has demonstrated efficacy in several research studies^8,31 (as well the current study). However, its limited accessibility—currently available only via the website www.self-growth-institute.com and not through official iOS or Android platforms—remains a barrier. Efforts are underway to address this limitation by expanding the availability of EFT-HP and similar evidence-based interventions on major app stores in the near future.

To enhance the generalizability of the current findings, it is essential that future research evaluates the effectiveness of the EFT-HP mobile application across diverse cultural, linguistic, and healthcare contexts. Cultural norms significantly influence how individuals experience, express, and manage emotional distress, including CF and self-compassion.⁷⁶ Thus, validating the intervention in cross-cultural settings will help determine whether its benefits are universally applicable or require contextual adaptation. Moreover, linguistic translation and cultural tailoring of psychological interventions have been shown to improve participant engagement and intervention efficacy.⁷⁷

In addition to broader population sampling, future studies should employ more rigorous research designs. While initial results are promising, RCTs remain the gold standard for establishing causal relationships and ruling out confounding variables.⁷⁸ Including active and passive control groups, ensuring randomization procedures, and implementing blinding when feasible can significantly strengthen the internal validity of outcomes. Further, long-term follow-up assessments are crucial to evaluate the sustained effects of interventions, particularly in high-stress helping professions where psychological strain can reemerge over time.⁷⁹ Further longitudinal studies should examine the durability of these effects and evaluate whether improved professional quality of life and CS translate into better patient outcomes.

Conclusion

Despite its brief 14-day duration, the mobile application version of the recently developed EFT-HP yielded significant improvements in CS, resilience, self-compassion, and compassion directed both toward and received from others. Additionally, significant reductions were observed in CF and self-criticism. These widespread positive outcomes highlight the promise of delivering EFT-HP through a mobile platform, presenting a cost-effective, scalable, and accessible intervention that may help mitigate occupational hazards associated with caregiving roles. Such a format may be particularly valuable for supporting the well-being of helping professionals in settings where traditional, in-person training is limited or unavailable.

Footnotes

Acknowledgements

The authors would like to acknowledge Katarína Greškovičová, Katarina Krizova, Bronislava Strnádelová, Jana Talianová for help with data collection.

ORCID iD

Júlia Halamová

Ethical approval

All procedures performed in studies involving human participants were by the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study's protocol was approved by the Ethical committee of Faculty of Social and Economic Sciences at Comenius University Bratislava FSEV 1647/-4/2022/SD-CIII/1.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Contributorship

JH designed the research. MK analyzed data. JH wrote the first draft of the article, all authors interpreted the results, revised the manuscript, and read and approved the final manuscript.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the EU NextGenerationEU through the Recovery and Resilience Plan for Slovakia, Vedecká Grantová Agentúra MŠVVaŠ SR a SAV (grant number 09I03-03-V04-00258, 1/0054/24).

Declaration of conflicting interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Availability of data and materials

The datasets generated and/or analyzed during the current study are not publicly available due the ethical reasons but are available from the corresponding author on reasonable request.

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Effectiveness of a mobile application the emotion-focused training for helping professionals in reducing compassion fatigue and enhancing compassion satisfaction and resilience

Abstract

Objective

Methods

Results

Conclusion

Keywords

Introduction

The research aim

Methods

The research sample

Power analysis

The research instruments

The short professional quality of life scale. 41

The Compassion Satisfaction and Compassion Fatigue Scale. 16

The Forms of Self-Criticism and Self-Reassurance Scale. 43

The Sussex-Oxford Compassion Scales for Self 45 and for Others 45 and From Others. 46

The 10-item Connor–Davidson Resilience Scale. 48

Research procedure

Research intervention

Mobile application usage protocol

Data analysis

Results

Overall pattern of change

Interrelationship among measures

Clinical significance of changes

Detailed statistical results

Discussion

Theoretical implications and mechanisms of change

Implications

Limitations and future directions

Conclusion

Footnotes

Acknowledgements

ORCID iD

Ethical approval

Informed consent

Contributorship

Funding

Declaration of conflicting interests

Availability of data and materials

References

The short professional quality of life scale.⁴¹

The Compassion Satisfaction and Compassion Fatigue Scale.¹⁶

The Forms of Self-Criticism and Self-Reassurance Scale.⁴³

The Sussex-Oxford Compassion Scales for Self⁴⁵ and for Others⁴⁵ and From Others.⁴⁶

The 10-item Connor–Davidson Resilience Scale.⁴⁸