Compassion focused therapy: an overview
Compassion focused therapy (CFT) is a relatively new trans diagnostic therapy. It is aimed at people who experience high levels of shame and self-criticism – attributes which are thought to underlie a wide range of mental health conditions.
Leah Millard, a PhD researcher with GMMH’s Perinatal Mental Health and Parenting (PRIME) Research Unit, recently carried out a systematic review about the effectiveness of compassion-focused therapy. She found that CFT was effective in reducing shame, self-criticism and mental health symptoms, particularly in women experiencing eating disorders.
Here she shares her insights from her research into CFT.
What is compassion focused therapy (CFT)?
“Compassion focused therapy (CFT) is a relatively new therapy that was first developed in the year 2000 by Prof. Paul Gilbert. Although there are a wide range of compassion-based interventions available, CFT differs in that it combines a broad range of approaches within psychology. These different areas include neuroscience, evolutionary, social, and developmental psychology as well as being rooted within Buddhist traditions. Within CFT, compassion is defined as “a sensitivity to the suffering in self and others, with a commitment to try to alleviate and prevent it” (Gilbert, 2014, p.19). In other words, compassion is learning to engage with suffering, as well as being motivated to learn the skills to reduce it.
“To alleviate suffering, CFT applies the six compassionate skills, which are compassionate imagery, attention, feeling, behaviour, reasoning, and sensory skills (Gilbert, 2014). These skills enable individuals to engage with the six key attributes of compassion (sensitivity, care for well-being, non-judgement, sympathy, sensitivity, and distress tolerance).”
Who is CFT aimed at?
“CFT is aimed at those who experience high levels of shame and self-criticism, which are thought to underlie a wide range of mental health conditions. Therefore, it is typically regarded as a trans-diagnostic intervention. CFT can be delivered to treat various mental health difficulties (i.e., clinical populations), as well as helping those with high levels of shame and self-criticism who do not necessarily have a diagnosed mental health condition (i.e., non-clinical populations). For my review on the current evidence base of CFT, I focused on studies that looked at its effectiveness with clinical populations.”
What were the main findings?
“My review aimed to provide a more rigorous methodological approach to evaluating CFT with clinical populations. Across 15 studies, CFT revealed significant reductions across compassion-related measures (i.e., shame, self-criticism), and mental health symptoms from the beginning to end of treatment. The therapy was shown to be particularly effective for women experiencing eating disorders. There were also significant improvements in levels of self-compassion across the studies.
“However, most of the studies did not measure whether the effects of CFT could be maintained once service-users had completed their treatment. Therefore, further exploration is needed into the long-term effects of CFT.”
How does CFT compare to other psychological interventions?
“The findings were unable to determine how CFT compares to other psychological interventions. This conclusion is primarily due to a lack of evidence, as there are currently not enough studies comparing CFT with other types of therapy. However, CFT was generally favourable compared to those who had received no treatment (i.e., on a waitlist for treatment, or receiving treatment-as-usual). It would be interesting for future studies to see how CFT compares to other more ‘popular’ interventions such as cognitive-behavioural therapy (CBT).”
What clinical implications has your review identified?
“The clinical implications of CFT are promising. This review demonstrated that CFT is generally effective in improving compassion-based outcomes and symptomology across a range of clinical samples, supporting the view of CFT being a trans-diagnostic intervention.
“Across the studies, CFT was most delivered within a group format with only two studies offering the intervention on a 1-to-1 basis. Therefore, these results are most applicable to CFT being offered as a group therapy. Based on these findings, the clinical implications of CFT as an individual therapy remains unclear.
“Retention rates within the CFT interventions ranged from 52.4% to 100.0%, with an average of 84.6%. These retention levels indicate that CFT is highly acceptable among those experiencing mental health difficulties. Therefore, suggesting that CFT is acceptable within clinical settings.”
If you have any questions for Leah about her research, please feel free to contact her via email Leah.Millard@manchester.ac.uk or via Twitter @LeahMillard
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