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Objective: The study aimed to test a mindfulness compassion-based intervention for breast cancer survivors serving as peer counselors, exploring whether mindfulness influenced depressive symptoms via a serial pathway of self-compassion, compassion to others, anxiety reduction, and improved quality of life. Method: This 8-month study adopted the randomized controlled trial (RCT) design. Survivors who are diagnosed with breast and complete treatments for at least one year were recruited from outpatient department of the General Hospital Breast Center and non-profit organization. They were randomly assigned into MC-BMS experimental group (the 8 weekly mindfulness compassion-based integrated with body-mind-spirit group therapy), and BMS control group (8 weekly body-mind-spirit group therapy). Results: There was a similarity in increasing general QOL functioning between the BMS and MC-BMS groups. The better improvements in QOL symptoms distress were more favored in MC-BMS than BMS groups. For within-group analyses, significant improvements in the MC-BMS group were depressive symptoms, search for meaning, mindfulness, while the BMS group showed significant improvements in global health, and breast cancer-related functioning. The three serial mediation pathways indicated that increases in mindfulness predicted greater self-compassion, which was associated with increased compassion to others. This, in turn, led to reduced anxiety, enhanced quality of life and breast cancer-related functioning, and ultimately, reduced depression. Conclusions: Enhancing mindfulness and compassionate processes in peer-counselor training serve a central role in improving anxiety and functional quality of life, thereby alleviating depressive symptoms in breast cancer survivors.
