-- 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 --

Approximately one in four to one in three university students experience a common mental health disorder within a given year (Auerbach et al., 2016, 2018), with mental distress rising among university students over time while overall levels of resilience and well-being appear to be declining (Curran & Hill, 2019). This trend is particularly concerning among healthcare students, where burnout is increasingly common (Prendergast et al., 2024) and linked to poorer academic engagement, reduced mental health, and impaired professional growth (Bullock et al., 2017). Mindfulness- and compassion-based interventions (Wang et al., 2024), as well as socio-emotional learning programs (Gandía-Carbonell et al., 2025), offer promising approaches for improving mental health outcomes such as depression, anxiety, stress, burnout, and for building resilience among healthcare students (Barbosa et al., 2013; van den Riet et al., 2018). In recent years, classic mindfulness-based interventions (MBI’s) focusing on mental practices done alone, have been further developed to also include social practices done with a partner, so-called Dyads (Kok & Singer, 2017), particular to improve social skills such as empathy and (self)compassion and social cohesion (for a review, see Singer, 2025). Despite growing research efforts to support student well-being through such interventions, partner-based Dyads have not yet been investigated in healthcare student populations. Current evidence indicates that these social practice formats may be more effective than classic solitary mindfulness practices in reducing loneliness and social stress, strengthening social connection and cohesion, and enhancing resilience and optimism—factors associated with improved psychological functioning (Matthäus et al., 2024a; Matthäus et al., 2024b; Godara, et al., 2021; Godara et al., 2024). Moreover, findings suggest that the mechanisms underlying dyadic social practices differ from those of traditional mindfulness-based interventions (Godara et al., 2024; Singer, 2025). Social capacities such as empathy and (self)compassion as well as deep listening are central socio-emotional skill in health care, supporting effective communication and emotional understanding (Beck et al., 2002; Derksen et al., 2013; Sinclair et al., 2017). Evidence indicates, however, that healthy empathy can also turn into empathic distress when one is constantly confronted with others’ suffering, whereas compassion has been shown to be more resilient and protective in coping with suffering as it is based on altruistic and care-based motivational systems associated with positive affect (Singer & Klimecki, 2014). Empathy and compassion rely on distinct psychological and neuronal mechanisms, with compassion engaging regulatory processes that help buffer emotional overwhelm and support resilience (Klimecki et al., 2014; Singer & Klimecki, 2014). Despite the important distinction between empathy and compassion, especially for personal in health care, it has so far not been taught to medical students in a systematic and evidence-based manner. To fill this gab, the Edu:Social Health Care project will employ an intervention program, the empathy-compassion Dyad training program (EMCO) in which students will be systematically taught to distinguish between empathic listening and how to regulate empathy (fist 4 weeks) and compassionate listening (second 4 weeks). In adding this component and bringing these programs to the field of health Care providers, the Edu:Social Health Care project extends the CovSocial project (for a review, see Singer, 2025) and the preceding ReSource project (see Singer et al., 2016; for a review Singer & Engert, 2019), both of which demonstrated the effectiveness of partner-based dyadic mental training interventions for inducing brain plasticity, reducing stress, enhancing psychological resilience, and strengthening social cohesion across multiple traits and state-level indicators of biopsychosocial health (Godara et al., 2021; Godara & Singer, 2024a, 2024b; Kok & Singer, 2017a, 2017b; Matthäus et al., 2024a; Matthäus et al., 2024b; O’Malley et al., 2024; Silveira et al., 2023; Singer et al., 2016; Singer, 2025; Singer & Engert, 2019). The EMCO training builds on the Affect Dyad originally developed in the ReSource project (Kok & Singer, 2017a) and the 10-week online coaching Dyad program implemented in the CovSocial project (Godara et al., 2024; Godara & Singer, 2024a), but adds the empathy versus compassion listening component to it and reduces the duration and coaching sessions from 10 to 8 weeks. Thus, we aim at testing a shorter version of earlier Dyadic online intervention programs, as these so far were 10 weeks long. Typical MBI’s such as MBSR or MBCT (Kabat Zinn, 1982; 2003; Teasdale et al., 2000), are usually 8 weeks long and thus easier to implement in practical fields such as education or healthcare. In sum, the first main goal of the proposed study is to test the efficacy of an adapted 8-week online empathy-compassion (EMCO)Dyad training program in the context of Health Care. A second main goal is to examine the effects of such Dyad intervention within the health care context, with a particular focus on strengthening students’ mental health, social skills, and social cohesion as well as fostering interprofessional attitudes by pairing study partners across different healthcare disciplines (e.g., nursing students with medical students). Intervention effects will be assessed across six main primary outcome families, here referred to as domains: 1) mental health, 2) resilience, 3) social cohesion and support, 4) social skills, 5) coping and emotion regulation, and 6) social behaviors. A third 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 daily Dyad practice. By combining students’ self-reported practice-related emotions with partner-based evaluations, this approach aims to generate new and innovate but more objective markers of training-induced changes in social emotions and listening quality over time in a real-live applied setting. The final aim is to investigate the cognitive and affective mechanisms underlying observed changes in students’ mental health, resilience, social cohesion, social skills and social behaviors (i.e., social-emotional competencies), as well as the mediating factors that may explain observed training-related effects in primary outcome domains. Based on previous research (Singer, 2025), 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.