{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:12:17Z","timestamp":1786119137749,"version":"build-2736575974"},"reference-count":56,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Objective<\/jats:title>\n Mindfulness-based cognitive therapy for children (MBCT-C) is an evidence-based intervention that requires further investigation in relation to its effectivness across diverse populations and prolonged follow-up durations. The present study aimed to develop a study protocol to evaluate MBCT-C in addressing internalizing and externalizing problems, as well as attention problems, among children from single-parent families.<\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n A two-arm randomized controlled trial (RCT) using crossover conditions is proposed. The intervention condition will receive twelve weekly sessions of MBCT-C group therapy, while the waitlist (WL) condition will initially serve as a control and then cross over to receive MBCT-C. A total of seventy-six children (aged 10\u201312) will be randomly allocated to the two study arms. Assessments will be conducted at baseline, post-intervention, and at 3-, 6-, 9-, and 12-month follow-ups. Participants will be assessed by the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL), and will respond to the Child Behavior Checklist (CBCL), Pediatric Symptom Checklist (PSC), Clinical Global Impressions (CGI), Mindfulness Inventory for Children and Adolescents (MICA), MBCT-C Adherence Scale (MBCT-C-AS), Mindfulness-Based Cognitive Therapy for Child and Parent Evaluation Questionnaire (MBCT-C\u2013CPEQ). Data will be analyzed using a mixed regression model in STATA 18.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n As this is a study protocol, no results are available to report at this time.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study protocol is the first attempt to evaluate the long-term effectiveness of MBCT-C using a crossover RCT that will help develop interventions tailored to internalizing, externalizing, and attention problems among children from single-parent families.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0354802","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T17:31:18Z","timestamp":1786037478000},"page":"e0354802","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mindfulness-based cognitive therapy for children (MBCT-C) on internalizing, externalizing, and attention problems in children from single-parent families: A study protocol for a crossover randomized clinical trial"],"prefix":"10.1371","volume":"21","author":[{"given":"Sara","family":"Jamali","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Rahimian-Boogar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5011-2823","authenticated-orcid":true,"given":"Mojtaba","family":"Habibi Asgarabad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"pone.0354802.ref001","author":"World Population Review","year":"2025"},{"key":"pone.0354802.ref002","volume-title":"World Population Prospects 2024: Summary of Results","author":"Department of Economic","year":"2024"},{"key":"pone.0354802.ref003","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.labeco.2018.08.003","article-title":"Parent\u2013child interactions and child outcomes: evidence from randomized intervention","volume":"54","author":"JH Kim","year":"2018","journal-title":"Labour Econ"},{"issue":"1","key":"pone.0354802.ref004","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.54516","article-title":"Parenting practices and well-being and health behaviors among young Asian American Children","volume":"8","author":"S Kwon","year":"2025","journal-title":"JAMA Network Open"},{"issue":"6","key":"pone.0354802.ref005","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1007\/s10826-019-01400-0","article-title":"A pilot study of the tuning in to kids parenting program in Iran for reducing preschool children\u2019s anxiety","volume":"28","author":"F Edrissi","year":"2019","journal-title":"J Child Fam Stud"},{"issue":"4","key":"pone.0354802.ref006","article-title":"Family structure, family instability, and child psychological well-being in the context of migration: evidence from sequence analysis in China","volume":"92","author":"Y Lu","year":"2021","journal-title":"Child Dev"},{"issue":"2","key":"pone.0354802.ref007","article-title":"The impact of family dynamics on children\u2019s mental health: systematic review","volume":"4","author":"NC Ani","year":"2024","journal-title":"Niger J Arts Hum"},{"issue":"1","key":"pone.0354802.ref008","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1177\/09731342231179017","article-title":"Single parenting: impact on child\u2019s development","volume":"19","author":"K Chavda","year":"2023","journal-title":"J Indian Assoc Child Adolescent Mental Health"},{"issue":"1","key":"pone.0354802.ref009","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1186\/s12978-024-01885-z","article-title":"Iranian single-child couples\u2019 perceptions and experiences regarding childbearing incentives","volume":"21","author":"F Seraj Shirvan","year":"2024","journal-title":"Reprod Health"},{"key":"pone.0354802.ref010","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.ssresearch.2015.05.012","article-title":"Single-parent households and children\u2019s educational achievement: a state-level analysis","volume":"53","author":"PR Amato","year":"2015","journal-title":"Soc Sci Res"},{"issue":"2","key":"pone.0354802.ref011","article-title":"Health outcomes, healthcare use and development in children born into or growing up in single-parent households: a systematic review study protocol","volume":"11","author":"I Lut","year":"2021","journal-title":"BMJ Open"},{"key":"pone.0354802.ref012","doi-asserted-by":"crossref","first-page":"101743","DOI":"10.1016\/j.ctcp.2023.101743","article-title":"Mindfulness group intervention improved self-compassion and resilience of children from single-parent families in Tibetan areas","volume":"51","author":"T Guo","year":"2023","journal-title":"Complement Ther Clin Pract"},{"key":"pone.0354802.ref013","doi-asserted-by":"crossref","first-page":"102194","DOI":"10.1016\/j.cpr.2022.102194","article-title":"Child executive function and future externalizing and internalizing problems: a meta-analysis of prospective longitudinal studies","volume":"97","author":"Y Yang","year":"2022","journal-title":"Clin Psychol Rev"},{"issue":"6","key":"pone.0354802.ref014","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1001\/jamapsychiatry.2025.0482","article-title":"Cognitive behavior therapy for mental disorders in adults: a unified series of meta-analyses","volume":"82","author":"P Cuijpers","year":"2025","journal-title":"JAMA Psychiatry"},{"issue":"3","key":"pone.0354802.ref015","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1017\/bec.2021.6","article-title":"Transdiagnostic versus construct-specific cognitive behavioural therapy for emotional disorders in patients with high anxiety sensitivity: a double-blind randomised clinical trial","volume":"38","author":"R Ahmadi","year":"2021","journal-title":"Behav Change"},{"issue":"3","key":"pone.0354802.ref016","doi-asserted-by":"crossref","first-page":"279","DOI":"10.4103\/IJPSYM.IJPSYM_470_18","article-title":"Cognitive behavior therapy for children and adolescents: challenges and gaps in practice","volume":"41","author":"S Halder","year":"2019","journal-title":"Indian J Psychol Med"},{"issue":"8","key":"pone.0354802.ref017","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1080\/10503307.2018.1464681","article-title":"A systematic review exploring therapist competence, adherence, and therapy outcomes in individual CBT for children and young people","volume":"29","author":"HA Rapley","year":"2019","journal-title":"Psychother Res"},{"issue":"11","key":"pone.0354802.ref018","doi-asserted-by":"crossref","first-page":"2277","DOI":"10.1007\/s12671-019-01193-9","article-title":"Mindfulness-Based Cognitive Therapy for Children (MBCT-C) for prevention of internalizing difficulties: a small randomized controlled trial with Australian primary school children","volume":"10","author":"KM Wright","year":"2019","journal-title":"Mindfulness"},{"issue":"1","key":"pone.0354802.ref019","article-title":"Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents","volume":"1","author":"R Featherston","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"pone.0354802.ref020","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1093\/bmb\/ldab005","article-title":"Mindfulness-based interventions: an overall review","volume":"138","author":"D Zhang","year":"2021","journal-title":"Br Med Bull"},{"key":"pone.0354802.ref021","volume-title":"Mindfulness-based cognitive therapy for anxious children: A manual for treating childhood anxiety","author":"RJ Semple","year":"2007"},{"issue":"2","key":"pone.0354802.ref022","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1080\/1045988X.2018.1528966","article-title":"The impact of mindfulness-based cognitive therapy on math anxiety in adolescents","volume":"63","author":"A LaGue","year":"2019","journal-title":"Prev School Failure: Alternative Educ Child Youth"},{"issue":"1","key":"pone.0354802.ref023","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1891\/0889.8391.22.1.15","article-title":"Mindfulness-based cognitive therapy for children: results of a pilot study","volume":"22","author":"J Lee","year":"2008","journal-title":"J Cogn Psychother"},{"issue":"4","key":"pone.0354802.ref024","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1007\/s10826-021-01924-4","article-title":"Mindfulness-based cognitive therapy as a targeted group intervention: examining children\u2019s changes in anxiety symptoms and mindfulness","volume":"30","author":"MM Syeda","year":"2021","journal-title":"J Child Fam Stud"},{"issue":"3","key":"pone.0354802.ref025","first-page":"47","article-title":"Effectiveness of mindfulness-based cognitive therapy on depression symptoms in children with divorced parents","volume":"5","author":"N Esmailian","year":"2013","journal-title":"J Clin Psychol"},{"issue":"1","key":"pone.0354802.ref026","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s12671-020-01506-3","article-title":"A randomized clinical trial of a modified mindfulness-based cognitive therapy for children hospitalized with cancer","volume":"12","author":"S Abedini","year":"2020","journal-title":"Mindfulness"},{"key":"pone.0354802.ref027","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.jad.2025.02.103","article-title":"Effectiveness of mindfulness-based cognitive therapy for treating generalized anxiety disorder and the moderating influence of abuse during childhood: a randomized controlled trial","volume":"379","author":"G Tang","year":"2025","journal-title":"J Affect Disord"},{"issue":"2","key":"pone.0354802.ref028","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1007\/s10826-009-9301-y","article-title":"A randomized trial of mindfulness-based cognitive therapy for children: promoting mindful attention to enhance social-emotional resiliency in children","volume":"19","author":"RJ Semple","year":"2009","journal-title":"J Child Fam Stud"},{"issue":"2","key":"pone.0354802.ref029","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s12671-010-0017-2","article-title":"Does mindfulness meditation enhance attention? A randomized controlled trial","volume":"1","author":"RJ Semple","year":"2010","journal-title":"Mindfulness"},{"issue":"4","key":"pone.0354802.ref030","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1891\/JCPSY-D-20-00014","article-title":"Efficacy of mindfulness based cognitive therapy on children with anxiety","volume":"34","author":"R Shetty","year":"2020","journal-title":"J Cogn Psychother"},{"issue":"4","key":"pone.0354802.ref031","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1089\/cap.2015.0054","article-title":"Neural function before and after mindfulness-based cognitive therapy in anxious adolescents at risk for developing bipolar disorder","volume":"26","author":"JR Strawn","year":"2016","journal-title":"J Child Adolesc Psychopharmacol"},{"issue":"4","key":"pone.0354802.ref032","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1891\/jcop.2005.19.4.379","article-title":"Treating anxiety with mindfulness: an open trial of mindfulness training for anxious children","volume":"19","author":"RJ Semple","year":"2005","journal-title":"J Cogn Psychother"},{"issue":"7","key":"pone.0354802.ref033","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1097\/00004583-199707000-00021","article-title":"Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data","volume":"36","author":"J Kaufman","year":"1997","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"3","key":"pone.0354802.ref034","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1111\/1467-8721.ep10768783","article-title":"Statistical power analysis","volume":"1","author":"J Cohen","year":"1992","journal-title":"Curr Directions Psychol Sci"},{"issue":"1","key":"pone.0354802.ref035","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1177\/1745691617709589","article-title":"Mind the hype: a critical evaluation and prescriptive agenda for research on mindfulness and meditation","volume":"13","author":"NT Van Dam","year":"2018","journal-title":"Perspect Psychol Sci"},{"issue":"2","key":"pone.0354802.ref036","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/j.1475-3588.2008.00518.x","article-title":"The reliability and validity of kiddie-schedule for affective disorders and schizophrenia - present and life-time version - Persian Version","volume":"15","author":"Z Shahrivar","year":"2010","journal-title":"Child Adolesc Ment Health"},{"key":"pone.0354802.ref037","first-page":"1","volume-title":"Ratings of relations between DSM-IV diagnostic categories and items of the CBCL\/6-18, TRF, and YSR","author":"TM Achenbach","year":"2001"},{"issue":"2","key":"pone.0354802.ref038","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/S0022-3476(88)80056-8","article-title":"Pediatric symptom checklist: screening school-age children for psychosocial dysfunction","volume":"112","author":"MS Jellinek","year":"1988","journal-title":"J Pediatrics"},{"key":"pone.0354802.ref039","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1186\/1471-2458-6-197","article-title":"Use of the pediatric symptom checklist for the detection of psychosocial problems in preventive child healthcare","volume":"6","author":"SA Reijneveld","year":"2006","journal-title":"BMC Public Health"},{"issue":"7","key":"pone.0354802.ref040","first-page":"28","article-title":"The clinical global impressions scale: applying a research tool in clinical practice","volume":"4","author":"J Busner","year":"2007","journal-title":"Psychiatry (Edgmont)"},{"issue":"2","key":"pone.0354802.ref041","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1002\/aur.2638","article-title":"Using the Clinical Global Impression scale to assess social communication change in minimally verbal children with autism spectrum disorder","volume":"15","author":"C Toolan","year":"2022","journal-title":"Autism Res"},{"issue":"4","key":"pone.0354802.ref042","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1037\/a0021338","article-title":"Assessing adolescent mindfulness: validation of an adapted Mindful Attention Awareness Scale in adolescent normative and psychiatric populations","volume":"23","author":"KW Brown","year":"2011","journal-title":"Psychol Assess"},{"issue":"6","key":"pone.0354802.ref043","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1007\/s12671-017-0719-9","article-title":"Measuring mindfulness in youth: review of current assessments, challenges, and future directions","volume":"8","author":"MS Goodman","year":"2017","journal-title":"Mindfulness"},{"issue":"7","key":"pone.0354802.ref044","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1111\/eip.13501","article-title":"Prevention of internalizing difficulties in the middle years: protocol for a noninferiority randomized trial of Mindfulness-Based Cognitive Therapy for Children and Cognitive Behavioural Therapy","volume":"18","author":"A Taylor","year":"2024","journal-title":"Early Interv Psychiatry"},{"issue":"4","key":"pone.0354802.ref045","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0317824","article-title":"Effectiveness and satisfaction of mindfulness-based cognitive therapy for children on anxiety, depression, and internet addiction in adolescents: Study protocol for a randomized control trial","volume":"20","author":"M Bakhtiari","year":"2025","journal-title":"PLoS One"},{"key":"pone.0354802.ref046","doi-asserted-by":"crossref","first-page":"1459434","DOI":"10.3389\/fped.2025.1459434","article-title":"The effectiveness of mindfulness-based cognitive therapy for children on anxiety, attentional control, and emotion regulation in children: a study protocol","volume":"13","author":"H Kholghi","year":"2025","journal-title":"Front Pediatr"},{"issue":"2","key":"pone.0354802.ref047","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1002\/da.20279","article-title":"The effect of anxiety disorder comorbidity on treatment resistant bipolar disorders","volume":"25","author":"JH Lee","year":"2008","journal-title":"Depress Anxiety"},{"issue":"2","key":"pone.0354802.ref048","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1111\/eip.12848","article-title":"Mindfulness-based cognitive therapy for children and adolescents with anxiety disorders at-risk for bipolar disorder: a psychoeducation waitlist controlled pilot trial","volume":"14","author":"S Cotton","year":"2020","journal-title":"Early Interv Psychiatry"},{"issue":"5","key":"pone.0354802.ref049","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1111\/cdev.13342","article-title":"The rise in single-mother families and children\u2019s cognitive development: evidence from three british birth cohorts","volume":"91","author":"S Harkness","year":"2020","journal-title":"Child Dev"},{"key":"pone.0354802.ref050","first-page":"161","article-title":"Chapter 8 - Mindfulness-Based Cognitive Therapy for Children.","volume-title":"Mindfulness-Based Treatment Approaches (Second Edition)","author":"RJ Semple","year":"2014"},{"issue":"2","key":"pone.0354802.ref051","doi-asserted-by":"crossref","first-page":"254","DOI":"10.3390\/pediatric16020022","article-title":"Effects of two online mindfulness-based interventions for early adolescents for attentional, emotional, and behavioral self-regulation","volume":"16","author":"B Porter","year":"2024","journal-title":"Pediatric Rep"},{"issue":"7","key":"pone.0354802.ref052","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1038\/s44220-023-00081-5","article-title":"Individual participant data systematic review and meta-analysis of randomised controlled trials assessing adult mindfulness-based programmes for mental health promotion in non-clinical settings","volume":"1","author":"Collaboration of Mindfulness Trials (CoMinT) 3","year":"2023","journal-title":"Nat Ment Health"},{"issue":"2","key":"pone.0354802.ref053","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1007\/s12671-021-01802-6","article-title":"The role of executive function in children\u2019s mindfulness experience","volume":"13","author":"KM Butterfield","year":"2021","journal-title":"Mindfulness"},{"issue":"5","key":"pone.0354802.ref054","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1037\/0021-9010.88.5.879","article-title":"Common method biases in behavioral research: a critical review of the literature and recommended remedies","volume":"88","author":"PM Podsakoff","year":"2003","journal-title":"J Appl Psychol"},{"key":"pone.0354802.ref055","doi-asserted-by":"crossref","DOI":"10.1002\/9780470712184","volume-title":"Cochrane handbook for systematic reviews of interventions","author":"JP Higgins","year":"2008"},{"key":"pone.0354802.ref056","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.brat.2016.06.004","article-title":"Addressing the treatment gap: a key challenge for extending evidence-based psychosocial interventions","volume":"88","author":"AE Kazdin","year":"2017","journal-title":"Behav Res Ther"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0354802","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T17:31:26Z","timestamp":1786037486000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0354802"}},"subtitle":[],"editor":[{"given":"Jan Christopher","family":"Cwik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":56,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,6]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0354802","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]}}}