Psychotherapeutic benefits of compassion-focused therapy: an early systematic review

J Leaviss, L Uttley, J Leaviss, L Uttley

Abstract

Background: Compassion-focused therapy (CFT) is a relatively novel form of psychotherapy that was developed for people who have mental health problems primarily linked to high shame and self-criticism. The aim of this early systematic review was to draw together the current research evidence of the effectiveness of CFT as a psychotherapeutic intervention, and to provide recommendations that may inform the development of further trials.

Method: A comprehensive search of electronic databases was undertaken to systematically identify literature relating to the effectiveness of CFT as a psychotherapeutic intervention. Reference lists of key journals were hand searched and contact with experts in the field was made to identify unpublished data.

Results: Fourteen studies were included in the review, including three randomized controlled studies. The findings from the included studies were, in the most part, favourable to CFT, and in particular seemed to be effective for people who were high in self-criticism.

Conclusions: CFT shows promise as an intervention for mood disorders, particularly those high in self-criticism. However, more large-scale, high-quality trials are needed before it can be considered evidence-based practice. The review highlights issues from the current evidence that may be used to inform such trials.

Keywords: psychotherapy.

Figures

Fig. 1.
Fig. 1.
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram (Moher et al. 2009). CFT, Compassion-focused therapy.

References

    1. Ashworth F, Gracey F, Gilbert P (2011). Compassion focused therapy after traumatic brain injury: theoretical foundations and a case illustration. Brain Impairment 12, 128–139.
    1. Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, Guyatt GH, Harbour RT, Haugh MC, Henry D, Hill S, Jaeschke R, Leng G, Liberati A, Magrini N, Mason J, Middleton P, Mrukowicz J, O'Connell D, Oxman AD, Phillips B, Schünemann HJ, Edejer T, Varonen H, Vist GE, Williams JW Jr., Zaza S; GRADE Working Group (2004). Grading quality of evidence and strength of recommendations. British Medical Journal 328, 1490.
    1. Barnard LK, Curry JF (2011). Self-compassion: conceptualizations, correlates, and interventions. Review of General Psychology 15, 289–303.
    1. Beaumont EA, Galpin AJ, Jenkins PE (2012). ‘Being kinder to myself’: a prospective comparative study, exploring post-trauma therapy outcome measures, for two groups of clients, receiving either cognitive behaviour therapy or cognitive behaviour therapy and compassionate mind training. Counselling Psychology Review 27, 31–43.
    1. Belsky J, Beaver KM (2011). Cumulative-genetic plasticity, parenting and adolescent self-regulation. Journal of Child Psychology and Psychiatry 52, 619–626.
    1. Braehler C, Gumley A, Harper J, Wallace S, Norrie J, Gilbert P (2013). Exploring change processes in compassion focused therapy in psychosis: results of a feasibility randomized controlled trial. British Journal of Clinical Psychology 52, 199–214.
    1. Bulmarsh E, Harkness KL, Stewart JG, Bagby RM (2009). Personality, stressful life events, and treatment response in major depression. Journal of Consulting and Clinical Psychology 77, 1067–1077.
    1. Buss DA (2009). The great struggles of life: Darwin and the emergence of evolutionary psychology. American Psychologist 64, 140–148.
    1. Carroll C, Patterson M, Wood S, Booth A, Rick J, Balain S (2007). A conceptual framework for implementation fidelity. Implementation Science 2, 1–9.
    1. Coan JA, Schaefer HS, Davidson RJ (2006). Lending a hand: social regulation of the neural response to threat. Psychological Science 17, 1032–1039.
    1. Cozolino LJ (2002). The Neuroscience of Psychotherapy: Building and Rebuilding the Human Brain. WW Norton & Company: New York, NY.
    1. Depue RA, Morrone-Strupinsky JV (2005). A neurobehavioral model of affiliative bonding: implications for conceptualizing a human trait of affiliation. Behavioral and Brain Sciences 28, 313–349.
    1. Fredrickson B, Cohn M, Coffey K, Finkel S (2008). Open hearts build lives: positive emotions, induced through loving-kindness meditation, build consequential personal resources. Journal of Personality and Social Psychology 95, 1045–1062.
    1. Gale C, Gilbert P, Read N, Goss K (2014). An evaluation of the impact of introducing compassion focused therapy to a standard treatment programme for people with eating disorders. Clinical Psychology and Psychotherapy 21, 1–12.
    1. Gilbert P (2000). Social mentalities: internal ‘social’ conflict and the role of inner warmth and compassion in cognitive therapy In Genes on the Couch: Explorations in Evolutionary Psychotherapy (ed. Gilbert P. and Bailey K. G.), pp. 118–150, Brunner-Routledge: East Sussex, UK.
    1. Gilbert P (2009a). Developing a compassion-focused approach in cognitive behavioural therapy In Cognitive Behaviour Therapy: A Guide for the Practising Clinician, vol. 2 (ed. Simos G), pp. 205–220 Routledge: East Sussex, UK.
    1. Gilbert P (2009b). Introducing compassion-focused therapy. Advances in Psychiatric Treatment 15, 199–208.
    1. Gilbert P (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology 53, 6–41.
    1. Gilbert P, Irons C (2004). A pilot exploration of the use of compassionate images in a group of self-critical people. Memory 12, 507–516.
    1. Gilbert P, Procter S (2006). Compassionate mind training for people with high shame and self-criticism: overview and pilot study of a group therapy approach. Clinical Psychology and Psychotherapy 13, 353–379.
    1. Gilroy A (2006). Art Therapy, Research and Evidence-Based Practice. Sage Publications Ltd: London.
    1. Hawe P, Shiell A, Riley T (2004). Complex interventions: how ‘out-of-control’ can a randomised controlled trial be? British Medical Journal 328, 1561–1563.
    1. Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA; Cochrane Bias Methods Group; Cochrane Statistical Methods Group (2011). The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. British Medical Journal 343, d5928.
    1. Hofmann SG, Grossman P, Hinton DE (2011). Loving-kindness and compassion meditation: potential for psychological interventions. Clinical Psychology Review 31, 1126–1132.
    1. Jazaieri H, Jinpa GT, McGonigal K, Rosenberg EL, Finkelstein J, Simon-Thomas E, Cullen M, Doty JR, Gross JJ, Goldin PR (2013). Enhancing compassion: a randomized controlled trial of a compassion cultivation training program. Journal of Happiness Studies 14, 1113–1126.
    1. Judge L, Cleghorn A, McEwan K, Gilbert P (2012). An exploration of group-based compassion focused therapy for a heterogeneous range of clients presenting to a community mental health team. International Journal of Cognitive Therapy 5, 420–429.
    1. Kelly AC, Zuroff DC, Foa CL, Gilbert P (2010). Who benefits from training in self-compassionate self-regulation? A study of smoking reduction. Journal of Social and Clinical Psychology 29, 727–755.
    1. Kelly AC, Zuroff DC, Shapira LB (2009). Soothing oneself and resisting self-attacks: the treatment of two intrapersonal deficits in depression vulnerability. Cognitive Therapy and Research 33, 301–313.
    1. Kirsch P, Esslinger C, Chen Q, Mier D, Lis S, Siddhanti S, Gruppe H, Mattay VS, Gallhofer B, Meyer-Lindenberg A (2005). Oxytocin modulates neural circuitry for social cognition and fear in humans. Journal of Neuroscience 25, 11489–11493.
    1. Kuyken W, Watkins E, Holden E, White K, Taylor RS, Byford S, Evans A, Radford S, Teasdale JD, Dalgleish T (2010). How does mindfulness-based cognitive therapy work? Behaviour Research and Therapy 48, 1105–1112.
    1. Laithwaite H, O'Hanlon M, Collins P, Doyle P, Abraham L, Porter S, Gumley A (2009). Recovery after psychosis (RAP): a compassion focused programme for individuals residing in high security settings. Behavioural and Cognitive Psychotherapy 37, 511–526.
    1. Leary MR, Tate EB, Adams CE, Batts Allen A, Hancock J (2007). Self-compassion and reactions to unpleasant self-relevant events: the implications of treating oneself kindly. Journal of Personality and Social Psychology 92, 887–904.
    1. LeDoux J (1998). The Emotional Brain. Simon & Schuster: London.
    1. Lucre KM, Corten N (2013). An exploration of group compassion-focused therapy for personality disorder. Psychology and Psychotherapy 86, 387–400.
    1. Lutz A, Brefczynski-Lewis J, Johnstone T, Davidson RJ (2008). Regulation of the neural circuitry of emotion by compassion meditation: effects of meditative expertise. PLoS ONE 3, e1897.
    1. MacBeth A, Gumley A (2012). Exploring compassion: a meta-analysis of the association between self-compassion and psychopathology. Clinical Psychology Review 32, 545–552.
    1. Mayhew SL, Gilbert P (2008). Compassionate mind training with people who hear malevolent voices: a case series report. Clinical Psychology and Psychotherapy 15, 113–138.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of Internal Medicine 151, 264–269.
    1. Neely ME, Schallert DL, Mohammed SS, Roberts RM, Chen YJ (2009). Self-kindness when facing stress: the role of self-compassion, goal regulation, and support in college students’ well-being. Motivation and Emotion 33, 88–97.
    1. Neff KD, Kirkpatrick KL, Rude SS (2007). Self-compassion and adaptive psychological functioning. Journal of Research in Personality 41, 139–154.
    1. Neff KD, McGehee P (2010). Self-compassion and psychological resilience among adolescents and young adults. Self and Identity 9, 225–240.
    1. Neff KD, Vonk R (2009). Self-compassion versus global self-esteem: two different ways of relating to oneself. Journal of Personality 77, 23–50.
    1. Nesse R (2005). Evolutionary psychology and mental health In The Handbook of Evolutionary Psychology (ed. Buss D.), pp. 903–929 John Wiley and Sons: Hoboken, NJ.
    1. NICE (2004). Guideline Development Methods. Information for National Collaborating Centres and Guideline Developers. National Institute for Clinical Excellence: London.
    1. Nutbeam D (1998). Evaluating health promotion – progress, problems and solutions. Health Promotion International 13, 27–44.
    1. Pace TWW, Negi LT, Adame DD, Cole SP, Sivilli TI, Brown TD, Issa MJ, Raison CL (2009). Effect of compassion meditation on neuroendocrine, innate immune and behavioral responses to psychosocial stress. Psychoneuroendocrinology 34, 87–98.
    1. Pauley G, McPherson S (2010). The experience and meaning of compassion and self-compassion for individuals with depression or anxiety. Psychology and Psychotherapy 83, 129–143.
    1. Rector NA, Bagby RM, Segal ZV, Joffe RT, Levitt A (2000). Self-criticism and dependency in depressed patients treated with cognitive therapy or pharmacotherapy. Cognitive Therapy and Research 24, 571–584.
    1. Rockliff H, Gilbert P, McEwan K, Lightman S, Glover D (2008). A pilot exploration of heart rate variability and salivary cortisol responses to compassion-focused imagery. Journal of Clinical Neuropsychiatry 5, 132–139.
    1. Schanche E, Stiles TC, Mccullough L, Svartberg M, Nielsen GH (2011). The relationship between activating affects, inhibitory affects, and self-compassion in patients with Cluster C personality disorders. Psychotherapy (Chicago, Ill.) 48, 293–303.
    1. Shapira LB, Mongrain M (2010). The benefits of self-compassion and optimism exercises for individuals vulnerable to depression. Journal of Positive Psychology 5, 377–389.
    1. Singer T, Bolz M (2014). Compassion. Bridging Practice and Science (). Accessed 28 May 2014.
    1. Spring B, Neville K (2011). Evidence-based practice in clinical psychology In The Oxford Handbook of Clinical Psychology (ed. Barlow D. H. and Nathan P. E.), pp. 128–149 Oxford University Press: New York, NY.
    1. The Dalai Lama (2001). An Open Heart: Practicing Compassion in Everyday Life. Little Brown & Company: Boston, MA.
    1. Van Dam NT, Sheppard SC, Forsyth JP, Earleywine M (2011). Self-compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression. Journal of Anxiety Disorders 25, 123–130.
    1. Wood MJ, Molassiotis A, Payne S (2011). What research evidence is there for the use of art therapy in the management of symptoms in adults with cancer? A systematic review. Psycho-Oncology 20, 135–145.

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner