Online MBCT for Adjustment Disorder During COVID-19: Efficacy, Mechanisms, and RCT

A 4-week (30 days), unguided online adaptation of the Mindfulness-Based Cognitive Therapy (MBCT) program. The intervention consisted of six sequential modules delivered through a secure web platform, including guided mindfulness meditations, body scan, mindful movement, and cognitive-behavioral exercises. Participants received audio recordings, written materials, and reflective tasks, along with automated reminder emails. No therapist guidance was provided.

A 4-week, unguided online progressive muscle relaxation (PMR) program adapted from Bernstein and Borkovec's protocol. The program included six sequential modules teaching systematic tensing and relaxing of major muscle groups, gradually reducing the number of groups until relaxation could be achieved through recall alone. Materials included audio recordings, written instructions, and automated reminder emails. No therapist guidance was provided.

Participants in this arm received no active intervention during the 4-week waitlist period but completed all study assessments on the same schedule as intervention arms. After the waiting period, participants were offered the choice to take part in either the online MBCT or PMR program.