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Compassion interventions: The programmes, the evidence, and implications for research and practice
Abstract
Purpose. Over the last 10–15 years, there has been a substantive increase in compassion-based interventions aiming to improve psychological functioning and well- being.
Methods. This study provides an overview and synthesis of the currently available compassion-based interventions. What do these programmes looks like, what are their aims, and what is the state of evidence underpinning each of them?
Results. This overview has found at least eight different compassion-based interven- tions (e.g., Compassion-Focused Therapy, Mindful Self-Compassion, Cultivating Com- passion Training, Cognitively Based Compassion Training), with six having been evaluated in randomized controlled trials, and with a recent meta-analysis finding that compassion- based interventions produce moderate effect sizes for suffering and improved life satisfaction.
Conclusions. Although further research is warranted, the current state of evidence highlights the potential benefits of compassion-based interventions on a range of outcomes that clinicians can use in clinical practice with clients.
... In the last two decades, a number of compassion training programs have been developed and delivered in a number of communities and medical contexts (Kirby, 2017). While the scope of this chapter does not include an in-depth analysis of each of these programs, Kirby (2017) provides a thorough overview. ...
... While the scope of this chapter does not include an in-depth analysis of each of these programs, Kirby (2017) provides a thorough overview. Most formal compassion training programs are based on a weekly group skills training model where a certified trainer leads participants through a series of didactic, experiential, and discussion-based interventions aimed at developing and practicing compassion skills (Kirby, 2017). Great care and time is used to train instructors in the methods of both compassion training and group facilitation. ...
... The Cultivating Emotional Balance (CEB) program was developed by prominent psychologist Paul Eckman and his colleagues (Eckman & Eckman, 2013). CEB aims to help people develop methods of managing emotions to build greater happiness and wellbeing (Kirby, 2017). The program combines modern psychology-particularly research on emotion-with Buddhist contemplative practices. ...
Global rates of stress and mental health distress have reached all-time highs. Given the scale of the problem, the development and dissemination of stress management strategies ought to be accessible, trainable, and low-cost. Growing evidence indicates that the utilization of compassion-based skills has positive effects on stress reduction, enhanced mental wellbeing, and emotional resilience. In this chapter, the science of compassion will be highlighted and reviewed. This chapter explores the psychological and neurobiological foundations of compassion and how those factors can be trainable motivations and behaviors. The science of compassion demonstrates that people can reduce stress in their lives by engendering the perspective taking, emotion regulation, and relational skills within compassionate behaviors. Given contemporary workplace stressors, the application of compassion to address stress and wellbeing in the workplace is explored.
... Drawing on various approaches from neuroscience, evolutionary, developmental and social psychology and Buddhist traditions, Compassion Focused Therapy (CFT) is considered part of the 'thirdwave' of cognitive and behavioural therapies, which apply emphasis on mindfulness, acceptance, meta-cognition, emotions, values and goals (Carvalho et al., 2017). Developed in the year 2000 by clinical psychologist Paul Gilbert, its objective is to bring compassion to human suffering through its transdiagnostic approach (Craig et al., 2020;Gilbert, 2000Gilbert, , 2014Kirby, 2017). Compassion is defined as "a sensitivity to suffering in self and others, with a commitment to try to alleviate and prevent it" (Gilbert, 2014, p. 19). ...
... CFT diverges from other compassion-based interventions through its psychoeducation that is underlined by different theoretical approaches (i.e., Buddhist psychology, neuroscience, social psychology) and their relation to physiological and neurophysiological processes such as the parasympathetic nervous system (Kirby, 2017). These systems aim to be directly stimulated through compassion-based exercises (Kirby, 2017). ...
... CFT diverges from other compassion-based interventions through its psychoeducation that is underlined by different theoretical approaches (i.e., Buddhist psychology, neuroscience, social psychology) and their relation to physiological and neurophysiological processes such as the parasympathetic nervous system (Kirby, 2017). These systems aim to be directly stimulated through compassion-based exercises (Kirby, 2017). Moreover, CFT is considered a type of psychotherapy, which differs from other evidence-based compassionate and mindfulness therapies, such as Mindful Self-Compassion and Compassion Cultivation Training (Jazaieri et al., 2013) which are considered manualised interventions (Kirby, 2017). ...
Background
Over the last 20 years, compassion focused therapy (CFT) has gained popularity as an emerging ‘third wave’ intervention. Although previous reviews indicated its potential benefits, a systematic review and meta-analysis of CFT in those with mental health difficulties has yet to be conducted.
Methods
A systematic search of five databases was undertaken, focusing on randomised controlled trials and randomised pilot/feasibility studies of CFT only. No language restrictions were implemented. A narrative synthesis was conducted. Random effects meta-analyses were measured on levels of self-compassion, self-criticism/self-reassurance, fears of compassion and clinical symptomology.
Results
Fifteen studies from 2013 to 2022 were included. Findings suggested that CFT was effective in improving compassion-based outcomes and clinical symptomology from baseline to post-intervention and compared to waitlist control. A range of small to large effect sizes were reported for improvements in self-compassion (0.19–0.90), self-criticism (0.15–0.72), self-reassurance (0.43–0.81), fear of self-compassion (0.18), depression (0.24–0.25) and eating disorders (0.18–0.79). Meta-analyses favoured CFT in improving levels of self-compassion and self-reassurance than control groups.
Limitations
The methodological quality of many of the included studies (7/15) was rated as ‘unclear’ due to a lack of information. There was a distinct gender gap, with 76.1 % identifying as female participants.
Conclusions
This review was the first to examine the effectiveness of CFT in clinical populations. The results indicate that CFT has promising clinical implications, suggesting that the intervention increases compassion-based outcomes and reduces clinical symptomology in those with mental health difficulties. However, future research is required into the long-term effects of CFT.
... Las intervenciones basadas en compasión parecen mejorar los niveles de atención al momento presente, la compasión hacia uno mismo y el bienestar, así como reducir los síntomas de ansiedad y depresión 18,19 . Además, producen cambios socioemocionales (ejemplo, humanidad compartida y preocupación empática) 20,21 , habilidades clave para la práctica clínica. ...
... La amabilidad hacia uno mismo podría actuar como un factor protector frente a una autocrítica o autojuicio excesivo 31 . Además, sabemos que el entrenamiento en autocompasión produce mejoras a nivel personal y en las habilidades profesionales necesarias para ejercer la medicina de forma óptima 18 . ...
... Habilidades de mindfulness: en especial los aspectos de observación, no reactividad y no juicio a las experiencias internas. Ser capaz de prestar atención al sufrimiento del momento presente y estar más comprometido en aliviarlo 16 son cualidades muy deseables en un futuro profesional de la medicina, ya que protegen su salud mental y mejoran la calidad del cuidado ofrecido a los pacientes 18 . ...
Resumen
Los médicos, los residentes y los estudiantes de Medicina soportan niveles de estrés, depresión y burnout superiores a la población en general. Este deterioro psicológico deriva en un cuidado menos compasivo de los pacientes. Sin embargo, las propuestas de las universidades y hospitales para prevenir esta situación son escasas y poco eficaces. Por esta razón, decidimos examinar la eficacia de un programa de entrenamiento en el cultivo de la compasión (CCT) en la prevención del malestar psicológico y en el aumento del bienestar en una muestra de estudiantes de Medicina de la Universidad Complutense de Madrid. Los participantes se dividieron aleatoriamente en 2 grupos: CCT y control en lista de espera. Ambos completaron encuestas online antes de la intervención, al terminarla y a los 2 meses de su finalización. Quienes recibieron el programa CCT tuvieron mejorías significativas en los niveles de compasión hacia uno mismo, mindfulness y regulación emocional, así como una reducción significativa de los niveles de ansiedad, estrés y agotamiento emocional. Algunos de estos efectos persistieron a los 2 meses de seguimiento. El CCT se postula como una intervención eficaz para cuidar la salud mental de los estudiantes de Medicina y favorecer el cuidado compasivo de los pacientes.
... One such intervention is Compassion-Focused Therapy (CFT: Gilbert, 2000Gilbert, , 2010a, which was originally developed as a psychotherapy for patients with high shame and self-criticism. CFT attempts to cultivate care-based motives, intents, and soothing affiliations, and alleviate persistent patterns of distress, to help people combat shame-based and traumatic experiences (Gilbert, 2020;Irons & Heriot-Maitland, 2021;Kirby, 2016). Compassionate Mind Training (CMT) is integrated in CFT and entails several practices to facilitate compassion and the psychoeducation that compassion is a sensitivity to suffering of oneself and others with a commitment to try to relieve and prevent suffering (Gilbert, 2017a). ...
... To cultivate compassion and well-being by reducing the impact of fears, blocks, and resistances, CMT provides psychoeducation that much of the suffering which humans experience is beyond their control and, therefore, is not their fault (Gilbert, 2009(Gilbert, , 2014. CMT comprises a series of practices designed to enhance sociality, friendliness, mindfulness, and well-being, particularly among people with high shame and self-criticism (Irons & Heriot-Maitland, 2021;Kirby, 2016;Matos et al., 2017a). These practices include physiological processes such as breathing (e.g., soothing rhythm breathing), imagery (e.g., safe space imagery), body posture, and voice tone training designed to facilitate self-awareness, self-grounding, and a sense of a compassionate self (Matos et al., 2017a). ...
... Despite the trans-diagnostic and multifaceted nature of CMT (Matos et al., 2017a), most of the research has been conducted in Western countries (Halamova et al., 2020). This is surprising given that almost all compassion-based interventions including CFT and CMT are influenced by Buddhist philosophies that are embraced across a range of predominantly Asian cultures (Kirby, 2016). Despite this, until recently, there has been a lack of research attempting to enhance compassion in Buddhist-influenced Asian cultures such as Japan (Arimitsu, 2016) and Sri Lanka (Kariyawasam et al., 2021(Kariyawasam et al., , 2022a. ...
Abstract
Objectives
Compassionate Mind Training (CMT) is a therapeutic approach proven to be effective for reducing distress and increasing well-being in clinical and non-clinical populations. This study aimed to explore the efficacy of a short-term, online version of the CMT on compassion, distress, and well-being in a cross-cultural, non-clinical sample of Sri Lankan and UK people.
Method
A randomized controlled trial with pre-, post-measurements, and a 2-week follow-up was conducted using CMT (n = 21 Sri Lankan, n = 73 UK) and wait-list control (n = 17 Sri Lankan, n = 54 UK) groups. The intervention effects were investigated using a series of repeated-measures ANOVAs using intention-to-treat and per-protocol analyses.
Results
The 2-week CMT was effective in increasing all aspects of compassion in both Sri Lankan and UK people. In addition, some cross-cultural similarities and differences (in the factors affecting compassion) were present in the improvements following CMT between the two countries, which were maintained at a 2-week follow-up.
Conclusion
This study provides promising evidence for the efficacy and cross-cultural applicability of CMT for reducing distress and increasing well-being.
... A face-valid proxy measure of compassion used in similar study designs (Fernando et al., 2017;Reynolds et al., 2019) was used to capture the two core elements of compassion in health [involving both feeling and motivational components, i.e., the awareness of suffering and a motivation to help (Gilbert, 2019;Jazaieri et al., 2014;Kirby, 2017;Strauss et al., 2016)]. Participants were asked how caring they felt towards the patient depicted in the vignette and how likely they would want to help. ...
... In understanding the present findings, we must first consider why urgency appears to lead to greater compassion. Having evolved as a response to suffering, compassion incorporates elements of both noticing suffering together with the motivation (and action) to alleviate it (Gilbert, 2019;Jazaieri et al., 2014;Kirby, 2017;Sinclair et al., 2016;Strauss et al., 2016). According to Gilbert's (2020) evolutionary perspective, the compassion system operates according to a 'stimulus -response' algorithm where the first part of the process entails detecting a signal for distress/need before being motivated to alleviate it (e.g., rescue, feed, thermoregulate). ...
Objectives:
To experimentally investigate whether more urgent patient presentations elicit greater compassion from health care professionals than less urgent, facilitating future research and thinking to address systemic barriers to compassion in health care.
Design:
This is a pre-registered online study with an experimental, within-subjects repeated-measure study design. Two clinical vignettes that systematically varied the urgency of patient presentation were utilized. Both vignettes depicted a patient with difficult behaviours typically associated with lower compassion.
Methods:
Health care professionals (doctors, nurses and allied health practitioners) recruited from all 20 District Health Boards across Aotearoa/New Zealand completed two vignettes in a counterbalanced order. Paired-sample t-tests were used to test the effect of the presentation urgency on indices of compassion.
Results:
A total of 939 participants completed the vignettes (20% doctors, 47%, nurses and 33% allied health professionals). As expected, participants reported greater care and motivation to help the more urgent patient. However, the more urgent patient was also perceived as less difficult, and exploratory analyses showed that perceived patient difficulty was associated with lower caring and motivation to help, particularly in the less urgent patient.
Conclusions:
This is the first work to experimentally test the relationship between the urgency of patient presentation and compassion in health care. Although the association between urgency and difficulty is complex, our findings are consonant with evolutionary views in which urgent distress elicits greater compassion. A system-wide orientation towards efficiency and urgency may exacerbate this 'bias' which must be addressed to ensure more equitable compassion in health care.
... Therefore, brief and low intensity interventions may help to overcome these problems, as they require less commitment of time and effort by the patient (Stein et al., 2021). Kirby (2017) reviewed different compassion-based interventions. The review concluded that there is a wide range of low-to high-intensity compassion interventions available, with notable differences in terms of focus and content. ...
... The review concluded that there is a wide range of low-to high-intensity compassion interventions available, with notable differences in terms of focus and content. Given the variation in the elements targeted by these interventions, Kirby (2017) emphasised the need to conduct component analyses for compassion-based interventions, to determine mechanisms of change, identify active components and remove passive components. In the previous trial (Turk et al., 2022), there was evidence for the effectiveness of the overall self-compassion intervention for state body shame. ...
State body shame is a risk factor for eating disorders, and self-compassion is emerging as a potentially effective treatment option in such cases. This study tested the efficacy of a brief (15-minute) self-compassion intervention in reducing state body shame. Using dismantling trial methodology, participants were randomly allocated to an active compassion condition (n = 23), an inactive control compassion condition (n = 23), or an educational control condition (n = 23). Measures of state body image and state shame were collected pre-intervention, immediately after the intervention, and a day after the intervention. Subjective units of state body shame (SUBS) were intensively measured during each invention. Self-compassion interventions were equally efficacious at protecting against deterioration of state body shame and were effective at reducing state shame compared to the educational control condition, with medium effect sizes (respectively - np2 = .07 and np2 = .08). Reductions in state shame were retained at follow-up. None of the interventions had an effect on body image (np2 = .04). Findings demonstrate the clinical promise of brief self-compassion interventions, particularly as evidenced-based "homework" exercises.
... There are several interventions [9,11] that can be used to lower self-criticism and increase self-compassion, since both of those constructs are evidently connected with psychopathology on the one hand and psychological and physical health on the other [12,13] as well as with well-being [14]. ...
... The basis of CCT is that compassion is the fundament of our human nature and is part of our everyday experience [15]. The individual sessions and exercises are focused on developing the following areas: soothing one's mind and concentrating through calming one's mind and breathing technique; meditation for developing kindness and compassion towards self and others; active compassionate practice, where individuals imagine that they can take on the pain and sadness of others and off er them their own happiness; integrated practice involving compassion development [11]. ...
Тренинг по развитию сострадания (ССТ) – это метод обучения, направленный на развитие сострадания, включающий различные медитативные практики и упражнения, улучшающие психическое и эмоциональное благополучие, сочувствие и доброту по отношению к другим и к себе. Цель исследования состояла в том, чтобы проанализировать влияние сокращенного онлайн-обучения «Тренинг по развитию сострадания» на уровень самокритики и сострадания к себе в доступной неклинической выборке из 117 участников. Данные были собраны до обучения, сразу после и через два месяца после завершения тренинга по развитию сострадания. Все участники были случайным образом распределены в экспериментальную или контрольную группу. При финальном измерении 24 участника были в экспериментальной группе и 30 участников в группе бесконтактного контроля. Анкета участников состояла из двух шкал: шкалы форм самокритики/атаки и самоуспокоения и шкалы самосострадания. Результаты исследования подтвердили эффективность онлайн-обучения, поскольку у участников экспериментальной группы было достигнуто достоверное повышение уровня сострадания к себе и снижение уровня самокритики. Исследование предлагает многообещающие результаты в том смысле, что сокращенная онлайн-версия тренинга продолжительностью 14 дней также эффективна не только для развития сострадания, но и для снижения самокритики.
The Compassion Cultivation Training (CCT) is an intervention aimed at compassion cultivation involving a variety of meditation practices and exercises enhancing mental and emotional well-being, empathy, and kindness towards others and oneself. The goal of the study was to analyze the effect of the shortened online intervention, The Compassion Cultivation Training, on the level of self-criticism and self-compassion in an available non-clinical sample of 117 participants. Data were collected before intervention, immediately after intervention, and two months after completion of the CCT. All participants were randomly assigned to the experimental or the control group. At the final measurement, 24 participants were in the intervention and 30 participants in the no-contact control group. The battery of administrated questionnaires consisted of two scales: The Forms of Self-Criticism/Attacking and Self-Reassuring Scale and the Self-Compassion Scale. The results of the research confirmed the effectiveness of online CCT intervention since the participants from the experimental group achieved a significant increase in the level of self-compassion and a decrease in the level of self-criticism. The study offers promising results in that the shortened online version of CCT lasting 14 days is also effective not just in cultivating compassion but also in decreasing self-criticism.
... Self-compassion is defined as the kindness toward the self and it is characterized by lack of self-judgment, acknowledging past trauma, and consideration of suffering as part of the human condition (Lazarus, 1991;Neff, 2003;Jazaieri et al., 2014). Kirby (2017) embodied this definition through their Compassion Cultivation Training. This program focused on promoting compassion toward others, in order to highlight positive outcomes, decrease suffering, and improve life satisfaction. ...
... Based on the existing literature (e.g., Strauss et al., 2016;Kirby, 2017), we structured a new Body Compassion Intervention on Body Image to promote a positive BI in women with a history of breast cancer. According to Table 1, this psychological intervention will consist of four group sessions focused on recognizing negative emotions, accepting uncomfortable feelings, and promoting BI in women after cancer treatment. ...
... In practising self-compassion, early childhood teachers can not only offer themselves kindness but develop a deepening awareness of their reciprocal interconnectedness to others. Neff's (2003a, b) original research exploring the concept of mindful self-compassion has been a catalyst for a substantive body of research into the practices and benefits of mindful self-compassion and compassion over the past 15 years (Kirby, 2017). In summarising the research related to selfcompassion and compassion practice, Kirby (2017) found several benefits, including improved mental health, emotion regulation, and social relationships. ...
... Neff's (2003a, b) original research exploring the concept of mindful self-compassion has been a catalyst for a substantive body of research into the practices and benefits of mindful self-compassion and compassion over the past 15 years (Kirby, 2017). In summarising the research related to selfcompassion and compassion practice, Kirby (2017) found several benefits, including improved mental health, emotion regulation, and social relationships. In a meta-analysis of the literature, Zessin et al. (2015) found a strong correlation between self-compassion and well-being. ...
Early childhood teaching is complex, caring, relational work. In enacting an ethic of care, early childhood teachers often focus on extending care to others, and overlook including themselves in a circle of care. This can negatively impact on teacher well-being and ultimately lead to teacher burnout. This paper draws on a project that explored twelve teachers’ experiences of the practice of mindful self-compassion using a methodology of mindful inquiry, a qualitative approach that includes elements of mindfulness, care, and hermeneutic phenomenology. Findings of the study identified that the practice of mindful self-compassion supported teachers to enact an ethic of care, which includes extending care, receiving care, and engaging in self-care. Being mindfully self-compassionate supported the teachers to engage in intentional caring practices that fostered relationships and supported the well-being of children and their colleagues, and empowered the teachers to advocate for themselves, their colleagues, and children. The paper argues that mindful self-compassion practice supports and sustains early childhood teachers in their caring role. When carers are included in a circle of care, then the reciprocal and inclusive nature of an ethic of care can be more fully realised. Implications are discussed for initial teacher education, teaching practice, early childhood leaders and policy makers.
... Et område, der har fået stigende opmaerksomhed i dagtilbudsforskning, omhandler Self-Compassion (SC) og compassion, blandt andet fordi højere grader af (self-)compassion i andre forskningsfelter er forbundet med lavere grad af depression og angst samt bedre trivsel (Kirby, Tellegen, & Steindl, 2017;Neff & Dahm, 2015;Macbeth & Gumley, 2012). Samtidig er der i (self-)compassion-forskningen generelt ikke enighed om, hvordan faenomenet SC skal karakteriseres (Kirby, 2017;Strauss et al., 2016;Jazaieri et al., 2013). En ofte anvendt definition af SC er Kristin Neffs (2003), som også var et inspirationsgrundlag for PE-elementet af naervaerende sammensatte kursus. ...
... I Neffs model er SC en kompleks forholdemåde, som inkluderer naervaer, venlighed og faellesmenneskelighed, og som yderligere involverer et omsorgsfuldt og aktivt handlende element (Neff & Dahm, 2015). På samme måde er det omsorgsfuldt handlingsorienterede aspekt centralt i den generelle compassion-forskning, eksempelvis for at adskille compassion fra (social) empati og mindfulness, som kan vaere klart observerende eller medfølende uden den omsorgsfulde handlingsparathed (Kirby, 2017). ...
Interessen for self-compassion er stigende inden for det pædagogiske område, men studier, der undersøger, hvordan pædagoger oplever at rette omsorg mod dem selv, og hvilken betydning det får for institutionslivet, er sparsom. Artiklen her undersøger, hvordan 24 pædagoger, der har deltaget i et sammensat kursusforløb, oplever fænomenet Professionel Egenomsorg, og hvordan det viser sig i deres arbejde. Data er indsamlet som gruppe – og individuelle interviews samt deltagernes nedskrevne beskrivelser, som danner udgangspunkt for en fænomenologisk inspireret analyse. Karakteristisk for fænomenet er, at det forbindes med en intentionel perception af egen-kroppen, som øger mulighederne for ændrede attituder i det levede samspil med børn og kollegaer. I et kropsfænomenologisk inspireret perspektiv diskuteres analysens fund, med henblik på at bidrage til en nuanceret forståelse af fænomenet, og hvordan det influerer på både børn og voksnes institutionsliv.
... These studies suggest prayers of gratitude do indeed produce increased gratitude within the individual. Similarly, the loving-kindness meditation, or metta bhavna, is a Buddhist practice used to cultivate loving-kindness, and research investigating its effects finds it does indeed increase compassion among practitioners (Kirby, 2017). ...
In order to offer a theological perspective of virtue development, we treat virtues as habitus, moral habits that are cultivated in local communities with transcendent belief narratives. Virtues are dependent on traditions to inform their purpose or telos and to give definition to the good life. Although psychology offers a conceptualization of virtues focused on the self-system—including characteristic adaptations and transcendent narrative identity—psychology is less clear on how virtues are shaped and informed by the beliefs and practices of their contextualized communities. An exploration of specific features of theological systems offers insight into virtue-enriching ecologies. Informed by Relational Developmental Systems metatheory, we propose a Virtues System framework and offer a researchable understanding of the embodied self-system embedded in multilevel contextual systems, with these systems being dynamically linked by meaning-making. We argue that meaning-making allows virtues to be enacted with the agility necessary to exhibit coherent moral agency across settings. Virtue Systems provide an integrative framework through which theology challenges psychology to consider a more holistic view of virtue development, to recognize religious and spiritual diversity, and to consider the importance of telos for informing sets of virtues. The Virtue Systems framework highlights how theological systems can be catalysts or obstructions to human thriving and flourishing societies, and offers an agenda for research that furthers the cultivation of virtue for the public good.
... Ter compaixão por si ou autocompaixão é uma prática que possibilita a liberação de recursos cognitivos e emocionais, que proporcionam o alívio do sofrimento de si (Baer, 2010). Trata-se de um constructo relacionado a uma variedade de desfechos positivos, em saúde mental (Ferrari et al., 2019), nos estudos realizados com populações de diferentes faixas etárias (Kirby, 2017;Marsh, Chan, & MacBeth, 2018;Zessin, Dickhäuser & Garbade, 2015). Maiores níveis de respostas autocompassivas estão relacionadas à redução de sintomas em transtornos depressivos (Bakker, Cox, Hubley & Owens, 2019); transtornos obsessivo--compulsivo (Eichholz et al., 2020) e transtornos alimentares (Hessler-Kaufmann, Heese, Berking, Voderholzer & Diedrich, 2020). ...
Esta revisão tem, por finalidade, descrever e examinar os resultados dos estudos sobre autocompaixão e sentido de vida. Os repositórios de dados acessados para o levantamento das evidências foram: Embase, Medline, Periódico CAPES, PsycInfo, Scopus (Elsevier) e Web of Science. Os resultados indicaram que uma associação positiva entre sentido de vida e autocompaixão possibilita o bem-estar subjetivo e desfechos positivos em saúde mental. As respostas autocompassivas estão relacionadas à qualidade das relações e afeto, que trazem consequências para o funcionamento psíquico e a expressão noética. Os achados do EXMIND identificaram uma predição de níveis prévios de autocompaixão e sentido de vida dos participantes, nos resultados da bondade consigo. Sugere-se que os próximos estudos sobre autocompaixão, sentido de vida e atenção plena avaliem como a interação entre autocuidado, estilo de apego, autocompaixão e o sentido de vida influenciam a entrada, permanência e resultados obtidos pelos participantes com as práticas de mindfulness.
... The second factor (compassion) captured items related to the ability to be compassionate and feeling connected, empathetic, caring, and wanting to help. Being compassionate regulated our autonomic nervous system (Kirby, 2017;Kirby et al., 2017), while self-compassion promoted self-regulation through the reduction in symptoms of anxiety, depression, and maladaptive perfectionistic tendencies (Woodfin et al., 2021). Regarding the therapeutic process, compassion is increasingly observed as central to promote safety and self-soothing strategies (Gilbert, 2020). ...
Dissociative disorders (DDs) are characterized by a discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, bodily representation, motor control, and action. The life-threatening coronavirus disease 2019 (COVID-19) pandemic has been identified as a potentially traumatic event and may produce a wide range of mental health problems, such as depression, anxiety disorders, sleep disorders, and DD, stemming from pandemic- related events, such as sickness, isolation, losing loved ones, and fear for one’s life. In our conceptual analysis, we introduce the contribution of the structural dissociation of personality (SDP) theory and polyvagal theory to the conceptualization of the COVID-19 pandemic-triggered DD and the importance of assessing perceived safety in DD through neurophysiologically informed psychometric tools. In addition, we analyzed the contribution of eye movement desensitization and reprocessing (EMDR) to the treatment of the COVID- 19 pandemic-triggered DD and suggest possible neurobiological mechanisms of action of the EMDR. In particular, we propose that, through slow eye movements, the EMDR may promote an initial non-rapid-eye-movement sleep stage 1-like activity, a subsequent access to a slow-wave sleep activity, and an oxytocinergic neurotransmission that, in turn, may foster the functional coupling between paraventricular nucleus and both sympathetic and parasympathetic cardioinhibitory nuclei. Neurophysiologically informed psychometric tools for safety evaluation in DDs are discussed. Furthermore, clinical and public health implications are considered, combining the EMDR, SDP theory, and polyvagal conceptualizations in light of the potential dissociative symptomatology triggered by the COVID-19 pandemic.
... As compassion has been found to predict a variety of well-being factors (rather than high well-being predicting higher compassion) , compassion-focused interventions could also be effective means to reduce sleep difficulties. As cost-effective compassion interventions require comparatively brief initial training, increase compassion in a few months' time, and are flexible in the administration, time, and setting wise, they might be relatively accessible to various groups (Kirby, 2017). The effectiveness of compassion interventions as a preventive tool or as a light intervention against sleep difficulties, however, requires further research. ...
Introduction
This study investigated the cross‐sectional and longitudinal associations between self‐reported compassion and sleep quality.
Methods
The data came from the population‐based Young Finns Study with an 11‐year follow‐up on compassion and sleep (n = 1064). We used regression models, multilevel models, and cross‐lagged panel models to analyze the data.
Results
The results showed that high compassion was cross‐sectionally associated with lesser sleep deficiency and fewer sleep difficulties. High compassion also predicted fewer sleep difficulties over an 11‐year follow‐up (adjusted for age, gender, socioeconomic position in childhood and adulthood, body mass index, health behaviors, and working conditions). This association disappeared when controlling for depressive symptoms. The predictive pathway seemed to proceed more likely from high compassion to fewer sleep difficulties than vice versa.
Discussion
Compassion may buffer against sleep difficulties, possibly via reducing depressive symptoms.
... Researchers have investigated self-compassion as a potential method to help individuals overcome difficulties, leading to its application in interventions targeting diverse psychological disorders, medical conditions, and non-clinical populations (Braehler et al., 2013;Kelly & Carter, 2015;Ko et al., 2018;Krieger et al., 2019;Luo et al., 2018;Neff & Germer, 2013). The findings of these studies indicate positive outcomes, particularly in relation to reducing psychological distress (Barnard & Curry, 2011;Kirby, 2017;Kirby et al., 2017;Leaviss & Uttley, 2015). However, a growing body of empirical research has shed light on significant issues pertaining to the definition and measurement of self-compassion (Cleare et al., 2018;Coroiu et al., 2018;Muris et al., 2016). ...
Purpose
Previous compassion scales measured correlates or consequences of compassion, included mindfulness in their definition and do not fully operationalize the affective, cognitive, behavioral, and interpersonal skills involved in cultivating compassion. The proposed Compassion Questionnaires towards Self (CQS) and Others (CQO) aim to operationalize compassion towards self and others by grounding them in affective, cognitive, behavioral, and interpersonal dimensions with each representing a set of skills that can be cultivated through training and practice.
Methods
Based on the proposed theoretical approach, the CQS and CQO items were developed through consultations with a panel of eight graduate students and a group of ten experts in the field. A series of three studies were conducted to validate the questionnaires and test their clinical utility.
Results
Results from the three studies suggested the merging of the affective and cognitive dimensions, yielding three independent dimensions for both the CQS and CQO. These findings were additionally supported by convergent and discriminant evidence. In addition, results suggested that CQS and CQO subscales’ scores are moderately associated with mindfulness measures and are sensitive to mindfulness training or meditation practice and experience.
Conclusions.
The CQS and CQO are the first questionnaires that operationalize compassion towards self and others as sets of affective, cognitive, behavioral, and interpersonal skills/abilities that are independent from mindfulness, and they have important theoretical and practical implications. Limitations as well as theoretical and practical implications of the CQS and CQO are thoroughly discussed.
... 72 Although these interventions share a number of features, such as psychoeducation on the role of (self-) compassion for people's well-being, mindfulness exercises -which promote self-awareness and paying attention to the present moment, without judgment, and active experiential activities during which participants rehearse specific (self-) compassion strategies, there are also notable differences among them that are guided by specific theoretical underpinnings. 73 This implies that there is considerable variation across treatments regarding the competencies that are targeted (eg, empathy, distress tolerance, acceptance) as well as the methods that are employed (eg, meditation, guided imagery, cognitive techniques). ...
The present review addressed the relationship between two self-related concepts that are assumed to play a role in human resilience and well-being: self-esteem and self-compassion. Besides a theoretical exploration of both concepts, a meta-analysis (k = 76, N = 35,537 participants) was conducted to examine the magnitude of the relation between self-esteem and self-compassion and their links to indices of well-being and psychological problems. The average correlation between self-esteem and self-compassion was strong (r = 0.65, effect size = 0.71), suggesting that - despite some distinct features - the overlap between both self-related constructs is considerable. Self-esteem and self-compassion displayed relations of a similar magnitude to measures of well-being and psychological problems, and both concepts accounted for unique variance in these measures once controlling for their shared variance. Self-esteem and self-compassion can best be seen as complementary concepts and we invite researchers to look more at their joint protective role within a context of well-being and mental health as well as to their additive value in the treatment of people with psychological problems.
... The coding scheme was based on a review by Kirby in 2016, in which compassion-focused therapy, mindful self-compassion, compassion cultivation training, cognitively based compassion training and cultivating emotional balance were identified as existing and studied compassion-based interventions. 14 ...
Background:
There is increasing empirical evidence for the positive mental health effects of compassion-based interventions. Although numerous smartphone apps offering compassion-based interventions ('compassion apps') are now available for the general public, the quality of these apps has not yet been reviewed. A qualitative review of existing compassion apps serves as a crucial first step toward testing the efficacy of these apps, by identifying good-quality compassion apps that might be worth the investment of a scientific trial.
Aims:
The current study focuses on reviewing the quality of existing compassion apps.
Method:
Existing compassion apps were identified through searches in the Google Play Store and App Store. The 24 included apps were reviewed on their quality by using the Mobile App Rating Scale, and on their consistency with current evidence by comparing them to existing and studied compassion-based interventions.
Results:
Of the 24 included apps, eight were identified that met the criteria of being consistent with existing and studied compassion-based interventions, and acceptable to good overall quality. The other 16 apps failed to meet one or both of these criteria.
Conclusions:
Good-quality compassion apps are available, but many of the available apps fail to meet certain quality criteria. In particular, many apps failed to offer sufficient relevant and correct information, or failed to offer this information in an entertaining and interesting way. It is recommended that future compassion apps are based on a clear definition of compassion, offer evidence- and theory-based exercises and implement tools for increasing engagement.
... Finally, Self-reassurance, alternatively to self-criticism, is defined as the capacity of the self to be able to keep calm, encourage itself, and have feelings of warmth towards itself in moments of setbacks or adversity (Gilbert et al., 2004). Contrary to self-criticism, self-reassurance is associated with mental health and psychological well-being through the promotion of confrontational, resilient, and persevering qualities (Ehret et al., 2015;Kirby, 2016;Kotera et al., 2021). ...
Background
Self-criticism is a psychological process largely studied as a vulnerability factor for several psychological difficulties in the adult population and, to a lower extent, in adolescent samples. Thus, the availability of instruments to effectively capture this construct is important, especially for younger populations.
Objective
This study examined the factor structure, measurement invariance to group samples, and psychometric properties of the short version of the Forms of Self-criticism and Self-reassuring Scale (FSCRS-SF) in Portuguese adolescents in non-clinical and clinical samples.
Methods
Two non-clinical samples (N = 1224 and N = 140) and a clinical sample (N = 103) were used. Participants’ ages ranged between 12 and 18 years old for both genders. Participants voluntarily completed a set of self-report questionnaires in the classroom. 418 adolescents completed the FSCRS 6-weeks after the first administration.
Results
Confirmatory factor analyses showed that the factor structure of the FSCRS-SF was similar to the one found in the adults’ version, with three factors (inadequate self, hated self, and reassured self). The measurement invariance was established for both samples. The FSCRS-SF revealed adequate to good construct validity, reliability, and temporal stability. Gender differences were found for the three subscales. Similarly, adolescents from the clinical sample reported higher levels of inadequate self and hated self and lower levels of reassured self in comparison with the non-clinical sample, as expected.
Conclusions
The FSCRS-SF was revealed to be a valid and reliable measure of self-criticism and self-reassurance for adolescents and seems to be a useful tool for research and clinical purposes.
... Empathy means compassion for others distinguishing with self-compassion while both are the critical competency of compassion (Gilbert et al., 2017). Evidence suggests that both empathy and self-compassion are correlated with wellbeing in children or young adults (Smith et al., 2018;Tan et al., 2011), although the literature further confirms that compassion-based interventions hold promise as a form of intervention to help cultivate both compassion for others and selfcompassion, reduce suffering (specifically depression, anxiety, and psychological distress), as well as increase well-being and life satisfaction (Kirby, 2017;Kirby et al., 2017). However, most of these interventions have been designed and implemented based on self-compassion, and compassion for others intervention programs have not received sufficient attention in research . ...
Well-being is an important indicator of an individual's mental health and each individual plays an agency role in their own well-being attainment. Empathy, as a positive emotional quality at the individual level, facilitating the establishment and maintenance of individual interpersonal relationships according to the interpersonal theory of empathy. This study investigated the relationship between empathy, social support and subjective well-being in a total of 191 children and adolescents with deaf and hard of hearing in two boarding special education schools after experiencing the COVID-19 pandemic from Henan Province of China. The results indicated that social support mediates the role of empathy and subjective well-being. The mediating role of social support between empathy and subjective well-being was mainly manifested as peer support rather than teacher support. Fostering empathy and creating a positive social support network among adolescents with deaf and hard of hearing would be effective in enhancing their subjective well-being.
... In recognition of the value of compassion for promoting well-being, a variety of programs have been developed with the aim of broadly cultivating compassion for both oneself and for others in adult community and clinical populations (Kirby, 2017); some examples are compassionate mind training and compassion cultivation training (Jazaieri et al., 2013). Recently, there have been calls for integration of compassion-based programing into settings reaching children and their caregivers, such as schools and families (Kirby, 2020;Lavelle Heineberg, 2016). ...
Caregivers of elementary-aged children are instrumental in shaping children’s understanding of and ability to regulate difficult emotions (e.g., sadness, anger, shame). Self-compassion has emerged as a useful skill in promoting adaptive responses to difficult emotions in adults and teens but has been minimally explored in child and family contexts. This study used both qualitative and quantitative data to examine the feasibility, acceptability, and preliminary outcomes of a new online, synchronous program called Self-Compassion for Children and Caregivers (SCCC). This program offers six sessions of group-based co-learning for caregivers and their school-aged children. Twenty-eight caregivers (79% female, 79% White) recruited through university advertisements and a community-based organization completed close-ended surveys pre and post program and provided open-ended written feedback about their experience with the program. The program was feasible, with 93% of completers attending at least 5 of 6 classes. Content analysis of caregivers’ open-ended responses suggested high acceptability, with caregivers citing improvements in communication about and support for difficult emotions and caregiver-child bonding. However, the online learning format was not ideal for all dyads. Suggested changes may improve engagement and outcomes. Quantitative analysis confirmed qualitative findings, showing significant improvements in caregivers’ self-compassion, parenting stress, mindful parenting, and caregivers’ assessment of their children’s depression pre- versus post-program. Implications for intervention refinements and future studies are discussed.
... Informed by these large bodies of research, we have embedded elements of a short body-scan and a compassion mediation into the freside dialog. Compassion meditation in particular is associated with distinct improvements to prosocial behaviour, perspectivetaking, empathetic accuracy, and benefts to physical health and emotion regulation [35,59,125]. It is also considered an active ingredient of self-transcendent experiences, and compassion cultivation has demonstrated mitigating efects on self-criticism and isolation [36,109]. ...
... Multimodal evidence indicates that within an experimental group or population, compassion meditation interventions lead to both primary (e.g., compassion and altruism) and secondary benefits (e.g., hope and relationship satisfaction) for some people (Pace et al., 2009;Leiberg et al., 2011;Mascaro et al., 2012Mascaro et al., , 2016Mascaro et al., , 2021Wallmark et al., 2013;Bach and Guse, 2015;Roeser and Eccles, 2015;Hildebrandt et al., 2017;Kirby, 2017;Kirby et al., 2017;Matos et al., 2017;Brito-Pons et al., 2018;Ash et al., 2020;Austin et al., 2021). However, individual outcomes vary widely, and causal mechanisms remain obscure. ...
... physiological regulatory effects associated with compassion, including changes in stress and immune responses (Pace et al., 2010;Stellar et al., 2015). Just as anger can be felt in our bodies as tightness in our jaw, increased heart rate, or a sense of agitation, compassion has a somatic experience that researchers are uncovering is associated with widespread physiologic benefits (McCraty and Zayas, 2014;Stellar et al., 2015;Kirby, 2017;Volynets et al., 2020). Regarding the prospect of potential intervention, previous research has identified the belief that compassion is not a fixed trait -which was unanimous in our study population -as a prerequisite for effective compassion training (Sinclair et al., 2021b). ...
Background
Compassion is considered a fundamental human capacity instrumental to the creation of medicine and for patient-centered practice and innovations in healthcare. However, instead of nurturing and cultivating institutional compassion, many healthcare providers cite the health system itself as a direct barrier to standard care. The trend of compassion depletion begins with medical students and is often attributed to the culture of undergraduate medical training, where students experience an increased risk of depression, substance use, and suicidality.
Objectives
This qualitative study aims to develop a more comprehensive understanding of compassion as it relates to undergraduate medical education. We used focus groups with key stakeholders in medical education to characterize beliefs about the nature of compassion and to identify perceived barriers and facilitators to compassion within their daily responsibilities as educators and students.
Methods
Researchers conducted a series of virtual (Zoom) focus groups with stakeholders: Students ( N = 14), Small Group Advisors ( N = 11), and Medical Curriculum Leaders ( N = 4). Transcripts were thematically analyzed using MAXQDA software.
Results
Study participants described compassion as being more than empathy, demanding action, and capable of being cultivated. Stakeholders identified self-care, life experiences, and role models as facilitators. The consistently identified barriers to compassion were time constraints, culture, and burnout. Both medical students and those training them agreed on a general definition of compassion and that there are ways to cultivate more of it in their daily professional lives. They also agreed that undergraduate medical education – and the healthcare culture at large – does not deliberately foster compassion and may be directly contributing to its degradation by the content and pedagogies emphasized, the high rates of burnout and futility, and the overwhelming time constraints.
Discussion
Intentional instruction in and cultivation of compassion during undergraduate medical education could provide a critical first step for undergirding the professional culture of healthcare with more resilience and warm-hearted concern. Our finding that medical students and those training them agree about what compassion is and that there are specific and actionable ways to cultivate more of it in their professional lives highlights key changes that will promote a more compassionate training environment conducive to the experience and expression of compassion.
... CFT builds on traditional CBT principles and blends empirical knowledge from affective neuroscience, social and developmental psychology, and mindfulness. CFT has gathered a large body of evidence in the treatment of shame and self-blame in a wide range of clinical settings [e.g., [16,33,[36][37][38][39][40]]. ...
Background
People with mental disorders face frequent stigmatizing attitudes and behaviors from others. Importantly, they can internalize such negative attitudes and thus self-stigmatize. Self-stigma is involved in diminished coping skills leading to social avoidance and difficulties in adhering to care. Reducing self-stigma and its emotional corollary, shame, is thus crucial to attenuate the negative outcomes associated with mental illness. Compassion-focused therapy (CFT) is a third-wave cognitive behavioral therapy that targets shame reduction and hostile self-to-self relationship and allows for symptom improvement while increasing self-compassion. Although shame is a prominent part of the concept of self-stigma, the efficacy of CFT has never been evaluated in individuals with high levels of self-stigma. The purpose of this study is to evaluate the efficacy and acceptability of a group-based CFT program on self-stigma, compared to a psychoeducation program for self-stigma (Ending Self-Stigma) and to treatment as usual (TAU). We hypothesize that diminished shame and emotional dysregulation and increased self-compassion will mediate the relationship between self-stigma improvements post-therapy in the experimental group.
Methods
This seven-center trial will involve 336 participants diagnosed with a severe mental illness and/or autism spectrum disorder and reporting high levels of self-stigma. Participants will be randomized into one of three treatment arms: 12 week-treatment of compassion-focused therapy (experimental arm), 12 week-treatment of Psychoeducation (active control arm), and TAU (treatment as usual—passive control arm). The primary outcome is the decrease of self-stigma scores on a self-report scale, i.e., ISMI, at 12 weeks. Secondary endpoints include sustainability of self-stigma scores (ISMI) and self-reported scores regarding target psychological dimensions, e.g., shame and emotional regulation, social functioning, and psychiatric symptoms. Assessments are scheduled at pretreatment, post-treatment (at 12 weeks), and at 6-month follow-up. Acceptability will be evaluated via (i) the Credibility and Expectancy Questionnaire at T0, (ii) the Consumer Satisfaction Questionnaire for Psychotherapeutic Services posttreatment and at 6-month follow-up, (iii) attendance, and (iv) dropout rates.
Discussion
This study will evaluate the potential efficacy and acceptability of a group-based CFT program on the decrease of self-stigma and thereby contribute to the continuing development of evidence-based therapeutic interventions for the internalized stigma of mental and neurodevelopmental disorders.
Trial registration
ClinicalTrials.gov NCT05698589. Registered on January 26, 2023
... When faced with challenges, self-reassurance is the capacity to be self-validating, encouraging, sympathetic, to recall one's positive characteristics, and be reassuring to self when things go wrong [38]. Self-reassurance is linked to increased coping skills, resilience, and persistence [38][39][40][41] and neural markers of negative emotion are down-regulated during attempts to be reassuring to one's suffering [42,43]. In order to assess self-reassurance and to distinguish self-reassurance from different forms of self-criticizing, the Forms of Self-criticizing/Attacking & Self-Reassuring Scale was developed (FSCRS, [38,44]; Italian version in Poli et al. ...
Western psychology and social sciences have long emphasized the value of a positive attitude toward oneself. Previous research had developed psychometric tools assessing self-compassion, defined as being open to and moved by one's own suffering. However, self-compassion did not describe whether people actually applied such protective factors when acutely faced with threats. The Unconditional Self-Kindness Scale (USKS) was developed as a tool to measure the behavioral response of self-kindness during an acute presence of threat to the self and not just as a general attitude when threat is absent. Since it can be experienced even in the most challenging situations and may promote resilience, this kindness may be defined as unconditional. We validated the Italian version of the USKS and found that the scale retained a one-factor structure. The USKS showed sound psychometric properties and good convergent validity since it was found to show very strong correlations with the Self-Compassion Scale-Short-Form and the Reassure Self subscale of the Forms of Self-criticizing/Attacking and Self-Reassuring Scale (FSCRS). In addition, the USKS showed good discriminant validity since it was found to show a negative moderate correlation and a negative strong correlation with the HS subscale and with the IS subscale of the FSCRS, respectively. Finally, the USKS showed good test-retest reliability and its use is encouraged in clinical and research settings in which the assessment of a positive attitude toward oneself during an acute presence of threat to the self is of interest.
... Similarly, empathy shares a few similarities with compassion; however, it does not require action or sustain itself over an extended time. 1 In other words, compassion has two components: (1) feeling someone's suffering and (2) the ability to take action to relieve them from that suffering. 2,3 Several studies have shown that the com- • Avoid multitasking while listening. • Avoid interruptions. ...
... Therapists compassionately guide patients to realize that our functioning is not our fault (Cowan et al., 2016), while providing training (Compassionate Mind Training; CMT; Gilbert, 2010) on specific practices that speak to the triggers of the threat system and boost the soothing system, hence balancing the three emotion regulation systems (Gilbert, 2019). There is empirical evidence of CFT and other compassion-based interventions in reducing psychopathology, shame, and self-criticism, and improving well-being (Kirby, 2017;Leaviss & Uttley, 2015), particularly with adolescents (Bluth et al., 2016;Figueiredo et al., 2021), and of the protective role of self-compassion in test anxiety (O'Driscoll & McAleese, 2022). ...
Test anxiety (TA) is one of the most common difficulties for secondary school students, with a negative impact in performance, mental health and well-being, and involving high levels of shame, self-criticism, and experiential avoidance. TA may also be conceptualized through an evolutionary and contextual approach to human suffering. To the best of our knowledge, no study has covered this conceptualization, nor has any previous TA treatment been simultaneously manualized, psychotherapeutic, and co-integrated compassion, acceptance and mindfulness-based practices. Moreover, studies on the efficacy of individual treatments directed to TA in adolescents are scarce, and case studies provide a comprehensive, detailed, and useful input about new models and treatments to both researchers and practitioners. The AcAdeMiC Program (Acting with Acceptance, Mindfulness and Compassion to overcome Test/Exam Anxiety) is a manualized 12-session online individual psychotherapeutic intervention, aiming to decrease test anxiety and boost well-being, compassion, acceptance and mindfulness. This is the first study presenting the treatment of an adolescent with high levels of test anxiety using this program. The Reliable Change Index (RCI) showed improvement, and maintenance or increase of gains over time, across all targeted symptoms and processes. The AcAdeMiC was also qualitatively and quantitatively perceived as useful and effective at posttreatment. This clinical case study provides a first glance at the conceptualization and treatment of TA with the new AcAdeMiC program.
... This is to say that the cultivation of a sense of social connectedness and safeness may attenuate the deleterious effects of traumatic appraisals on the development and maintenance of depressive symptoms. Accordingly, compassionbased interventions (e.g., compassionate mind training, mindful self-compassion) have been found to reduce depression and anxiety, and increase well-being (Kirby, 2016). ...
The restrictions imposed to control the COVID-19 pandemic had significant negative effects on the mental health of the general population, and particularly in nurses as frontline healthcare workers. The main goal of the present study was to analyze the direct and indirect effects, via social connectedness, of centrality of the COVID-19 outbreak on depressive symptoms. Furthermore, it is explored whether this association varied by group (nurses versus general population). The global sample included 326 individuals from the community and 316 nurses, who were administered self-reported questionnaires. Results revealed that event centrality of COVID-19 outbreak was linked to depressive symptoms, both directly and through the deterioration of social connectedness; moreover, this indirect effect was significant for both subsamples. Interventions aimed at preventing the deterioration of social connectedness may facilitate the decrease of depressive symptoms in the aftermath of the pandemic, particularly for nurses.
... Possible psychological mechanisms subtending such improvements include the increase of mindfulness trait that promote awareness and acceptance of others (e.g., connectedness with others, increase of positive affects; Quaglia et al., 2016;Wallmark et al., 2013), or the reduction of stress and negative affects that are conversely related to reduced empathy (Kang et al., 2014;Oman et al., 2010). From the physiological point of view, the improvement in prosocial behaviors has been related to increased bodily relaxation (Kirby, 2017), changes in vagal tone (Kok et al., 2013) and altered activation in the prefrontal cortex (Mascaro et al., 2015;Weng et al., 2013), thus, suggesting that there is a link that connect perception of bodily states and quality of social interactions. Also, the "silencing" of the narrative self in favor of the minimal self is thought to underlie the ability to have a more embodied experience of the world that is, consequently, thought to promote greater openness toward others, positive affect, voluntarily acceptance, and awareness of ongoing experiences (Paoletti et al., 2022;. ...
Interoception is a perceptual process of gathering information on the physiological and functional state of the body. It is thought to underlie different affective and social processes such as emotional regulation, self-other distinction, understanding of others' emotions and, more generally, to support psychophysiological wellbeing. Recent studies have suggested that interoception plays an important role in the embodiment of abstract concepts as well, thus providing a link between perception of bodily signals and conceptual representations. Considering that contemplative practices such as meditation and mindfulness-based practices usually engage the practitioner in a focus on bodily sensations, contemplative practices are thought to foster enhanced bodily awareness and empathic behaviors through modulation of interoceptive functions, leading practitioners to have a more embodied experience of the world. In the current study, we compared a group of practitioners (N = 66) with a matched control group of non-practitioners, adopting self-report questionnaires examining interoceptive sensibility, empathy, and perceptual components of conceptual representations. Differences between the two groups were found, with practitioners showing greater interoceptive sensibility, greater empathy and overall greater perceptual experiences for both abstract and concrete concepts. However, a mediation analysis showed that interoceptive sensibility was observed to affect empathy through mediation of interoceptive components of conceptual representations only in the non-practitioners group. Considering that practitioners are trained to “ground” their experience in bodily sensations, this study suggests that embodying experiences in interoceptive sensations may be a crucial gateway to reach higher states of consciousness characterized by greater bodily sensibility and enhanced empathy.
... It can help individuals to develop positive psychological and behavioral self-regulation, attenuate their feelings about negative events, and improve interpersonal and social skills (Neff et al., 2008;Semenchuk et al., 2018;Zessin et al., 2015). Given the benefits derived from compassion, it is not surprising that it has become a core intervention target in therapeutic interventions (Craig et al., 2020;Forster & Kanske, 2021;Kirby, 2017), such as Mindful Self-Compassion Program (Neff & Germer, 2013), Cultivating Compassion Training (Jazaieri et al., 2013), Cognitively Based Compassion Training (Pace et al., 2013) and Compassionate Mind Training (Gilbert & Procter, 2006). In addition, Compassion Focused Therapy (CFT) is a psychotherapeutic model developed specifically for clinical populations who tend to have significant difficulties with These authors contributed equally: Jingyun Wang, Mingchun Guo. ...
Based on Beck’s cognitive model, this study aimed to examine the mediating role of self-acceptance in the relationships between parenting behaviors and fears of compassion from others/for self. A set of questionnaires were completed by 684 undergraduate students from a university in Fujian Province in China, and Structural Equation Modelling was employed to analyze the data. The results showed that parental care was positively associated with self-approval and self-evaluation, whereas parental overprotection was negatively related to self-approval and self-evaluation. Furthermore, self-approval contributed to fear of compassion from others and for self subsequently, and self-evaluation only contributed to fear of compassion for self subsequently. These findings support the mediating role of self-acceptance in the relationship between parental care/overprotection and fears of compassion from others/for self. In addition, the study found that self-approval, rather than self-evaluation, played a mediating role between parental care/overprotection and fear of compassion from others.
... In addition, it would be necessary to involve clinical samples in the analysis in future research. This future research might shed more light on the concept of self-criticism and self-compassion and contribute to creating new and more effective interventions and improving existing ones (e.g., Kirby, 2017). ...
As self-criticism is considered to be the major underlying factor of all sorts of psychopathology, it is meaningful to explore the differences between how people deal with their self-criticism based on their level of self-criticism. The aim of this study was to categorise descriptions and investigate differences between 5 high and 5 low self-critical participants in their self-critical, self-protective and self-compassionate imageries. The total sample consisted of 10 university students, who were selected from a larger sample of 88 participants based on their extreme score from The Forms of Self-Criticising/Attacking and Self-Reassuring Scale. For analysis, we exploited Consensual Qualitative Research with two assessors and one auditor. The compassionate imagery was used to evoke the inner critic, protector and compassionate voice. The results showed differences in the imageries based on the level of self-criticism. Both high and low self-critics displayed difficulties in overcoming their self-criticism. Contrary to high self-critics, low self-critics showed more constructive and positive strategies for dealing with their self-criticism. Our study presented several different patterns between high and low self-critical participants in self-critical, self-compassionate, and self-protective imagery which could be used for diagnostic purposes in the future.
... Different perspectives abound in the scientific literature, with compassion being conceptualised variously as a motivation, a disposition, a feeling, an attitude or as a multidimensional construct (Jazaieri et al., 2013;Seppälä et al., 2017;Strauss et al., 2016). Definitions of compassion and self-compassion also vary amongst the different compassion-based interventions (see Gilbert, 2017, Kirby, 2016and Strauss et al., 2016 for a review of compassion definitions). For example, mindful self-compassion (MSC; Neff & Germer, 2013), compassion cultivation training (CCT; Jazaieri et al., 2013), cognitively based compassion training (CBCT; Pace et al., 2009), and cultivating emotional balance (CEB; Kemeny et al., 2012) all offer nuanced definitions that vary. ...
Estudos empíricos têm documentado os benefícios da compaixão para a saúde mental, bem-estar psicossocial e fisiológico. No entanto, as definições de compaixão variam entre abordagens teóricas, investigadores, clínicos e leigos. O significado e a natureza da compaixão podem ser mal compreendidos e ligados a medos, bloqueios e resistências à compaixão. O presente artigo define a compaixão a partir da perspetiva da terapia focada na compaixão (TFC) e distingue-a de outros conceitos comumente associados, usando uma abordagem metodológica qualitativa. A compreensão dos participantes sobre o que é a compaixão foi explorada através da seleção das palavras que eles associavam com compaixão e auto-compaixão, e das suas descrições de experiências passadas de dar e receber compaixão, com diferenças culturais sendo também examinadas. Uma amostra de 584 participantes adultos foi recrutada da comunidade geral na Austrália (n = 296), Portugal (n = 183) e Singapura (n = 105), e completou um questionário de auto-resposta que avaliava o significado e as experiências subjetivas de compaixão. Empatia, Bondade e Compreensão foram as três palavras que os participantes mais frequentemente associaram a ‘Compaixão’. As três palavras mais frequentemente selecionadas pelos participantes associadas à ‘Auto-compaixão’ foram Aceitação, Força e Compreensão. Várias diferenças culturais entre os países foram identificadas e discutidas. As descobertas também esclareceram as experiências dos participantes de compaixão pelos outros, receber compaixão de outros e auto-compaixão, identificaram semelhanças e diferenças entre países e revelaram que uma proporção significativa de pessoas não conseguiu lembrar/descrever experiências de compaixão. Os resultados são discutidos à luz da abordagem de TFC e são derivadas implicações clínicas para psicoterapeutas de TFC.
... Meanwhile some authors see compassion from a trait perspective (e.g., Goetz, Keltner, & Simon-Thomas, 2010), the rationale behind compassion-based interventions is that compassion can be developed and enhanced through practice. In a recent review, Kirby (Kirby, 2016) identifies at least six compassion-based programs that differ in their degree of empirical evidence. These programs are: Compassion Focused Therapy (Gilbert & Procter, 2006), Mindful Self-Compassion Training (Germer & Neff, 2013), the Compassion Cultivation Training (Jazaieri et al., 2013), Cognitively Based Compassion Training (Ozawa-de Silva & Dodson-Lavelle, 2011), Cultivating Emotional Balance and Compassion (Kemeny et al., 2012) and Loving Kindness Meditations (Hofmann, Grossman, & Hinton, 2011). ...
Background:
An essential value in mental health care is compassion: awareness of suffering, tolerating difficult feelings in the face of suffering, and acting or being motivated to alleviate suffering. Currently, technologies for mental health care are on the rise and could offer several advantages, such as more options for self-management by clients and more accessible and economically viable care. However, digital mental health interventions (DMHIs) have not been widely implemented in daily practice. Developing and evaluating DMHIs around important mental health care values, such as compassion, could be key for a better integration of technology in the mental health care context.
Objective:
This systematic scoping review explored the literature for previous instances where technology for mental health care has been linked to compassion or empathy to investigate how DMHIs can support compassion in mental health care.
Methods:
Searches were conducted in the PsycINFO, PubMed, Scopus, and Web of Science databases, and screening by 2 reviewers resulted in 33 included articles. From these articles, we extracted the following data: technology types, goals, target groups, and roles of the technologies in the intervention; study designs; outcome measures; and the extent to which the technologies met a 5-step proposed definition of compassion.
Results:
We found 3 main ways in which technology can contribute to compassion in mental health care: by showing compassion to people, by enhancing self-compassion in people, or by facilitating compassion between people. However, none of the included technologies met all 5 elements of compassion nor were they evaluated in terms of compassion.
Conclusions:
We discuss the potential of compassionate technology, its challenges, and the need to evaluate technology for mental health care on compassion. Our findings could contribute to the development of compassionate technology, in which elements of compassion are explicitly embedded in its design, use, and evaluation.
... Research has consistently found that those with higher levels of compassion and self-compassion have better mental health (Zessin et al., 2015), and those that fear compassion have poorer mental health (Kirby et al., 2019). Interventions have been developed to help cultivate compassion to improve well-being, with meta-analytic research showing compassion-based interventions are effective in doing so (Kirby, 2017;Kirby et al., 2017). However, interventions are not always needed to facilitate compassion. ...
By definition, compassionate actions aim to relieve suffering. Perhaps, then, one barrier to compassion is a general lack of belief in the efficacy of one’s actions. Further, beliefs of inefficacy may relate to how coherently and stably one represents themselves; and action beliefs may mediate the recently identified correlation between self-concept clarity and helping behaviors. Using a preregistered design in two online samples totaling 484 participants, we investigate associations between self-reported self-concept clarity, action beliefs, and compassionate action (for self and others). As an objective measure of compassionate behavior, participants are given an opportunity to donate to charity. We control for fears of compassion as a commonly recognized barrier to compassionate action. Our data provide decisive evidence for moderate to large correlations between self-concept clarity, general sense of agency, self-efficacy, and self-reported compassionate action. In both samples, the action belief variables mediate the effect of self-concept clarity on self-reported compassion. Surprisingly, none of the measures were predictive of donation in either sample. Our data suggest that beliefs about action efficacy have a large impact on compassionate action as subjectively assessed and mediate the impact that self-concept clarity has on self-reported helping behaviors. However, these findings do not generalize to all helping behaviors, such as decisions about donating to a particular charity. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
... 22 23 Selfcompassion focused psychotherapy has been established as an effective intervention for people with psychological distress in various settings. [24][25][26] Moreover, many people tend to associate shameful feelings with their mental health problems; hence, care that focuses on negative factors, such as depression and stress, can amplify the shameful feelings, which can exacerbate poor mental health. [27][28][29] However, an approach that strengthened people's psychological assets has been revealed to be promising. ...
Introduction
An easy-to-access and effective psychotherapy for bereaved informal caregivers has not been established. People with higher self-compassion status tend to have lower bereavement related grief, psychotherapy focused on self-compassion can be promising for this population. This study aimed to examine the feasibility of online self-compassion focused psychotherapy for bereaved informal caregivers.
Method and analysis
A total of 60 study participants will undergo an intervention programme comprising online sessions of 2 hours per week for five consecutive weeks and undertake postsession work. The intervention personnel will comprise psychologists who have received more than 10 hours of structured training. The primary endpoint will be assessed on the intervention completion rate, with secondary endpoints consisting of the Complicated Grief Questionnaire, Patient Health Questionnaire-9, Generalised Anxiety Disorder-7, Brief Resilience Scale and Self-Compassion Scale. Evaluations will be conducted preintervention, immediately after intervention, and 4 and 12 weeks after intervention.
Ethics and dissemination
This study has been reviewed and approved by the Ethics Committee of the Kyoto University Graduate School and Faculty of Medicine, Kyoto University Hospital, Japan (Approved ID: C1565). The results of this study will be disseminated through publication in a peer-reviewed journal and conference presentations.
Trial registration number
UMIN000048554.
... Compassion is considered an evolutionarily advantageous trait for group survival and flourishing as it is related to altruism and cooperative behavior (Goetz et al., 2010). Findings indicate that it is possible to increase compassion through several different interventions (Kirby, 2017). There is evidence that short-term training in compassion increased activation in brain regions associated with social cognition and emotion regulation when seeing other individuals suffer, which was also followed by an increment in prosocial behavior-a core feature of compassion (Weng et al., 2013). ...
The Sussex-Oxford Compassion Scales (SOCS) are recently developed measures of compassion, which have showed support for a five-factor structure for both other-compassion (SOCS-O) and self-compassion (SOCS-S). The study aimed to validate the Swedish translations of both the SOCS-O and the SOCS-S. A sample of adult participants was randomly split into either an exploratory sample (N ¼ 403) or a replication sample (N ¼ 402). The exploratory sample was used for both exploratory factor analysis and confirmatory factor analysis. In the replication sample, we (1) used CFA to validate results from the exploratory sample, (2) assessed measurement invariance for different groups (gender, nationality, age), and (3) evaluated psychometric properties using local fit. Results from both sub-samples support the presence of five-factor models for both SOCS-O (using 19 items) and SOCS-S (using 20 items). For both scales, measurement invariance is supported for all grouping variables, and local psychometric properties indicate good internal consistency with fairly good discriminant and convergent validity. This study supports the five-factor model of both other-compassion and self-compassion, respectively, and shows that the Swedish versions of both SOCS-O and SOCS-S are reliable and valid instruments that can be used to index compassion with general adult populations in Sweden and Finland.
... Some scholars have argued that it is worthwhile to particularly focus on this defining feature of self-compassion to learn more about its unique role in people's resilience against mental health issues [41]. Meanwhile, it is good to bear in mind that compassion-based interventions often target other elements than self-kindness (e.g., mindfulness [42]), and there is some evidence that the enhancement of other components (e.g., mindfulness and common humanity) is needed to promote a more positive attitude toward oneself [43]. ...
Background and purpose:
Self-compassion is considered as a protective psychological construct that would shield against the development of emotional problems. The aim of the present study was to compare the 'protective nature' of two measures of self-compassion: the Self-Compassion Scale for Youth (SCS-Y) and the Sussex-Oxford Compassion for the Self Scale (SOCS-S).
Methods:
Eighty-seven adolescents aged 12 to 18 years completed both self-compassion measures as well as scales of anxiety and depression symptoms.
Results:
SCS-Y and SOCS-S scores were positively correlated, and for both measures it was generally found that higher levels of self-compassion were associated with lower levels of emotional symptoms. However, the uncompassionate self-responding scales of the SCS-Y correlated positively with anxiety and depression symptoms and hence can better be seen as indices of vulnerability. Regression analyses suggested that a positive attitude toward oneself, as measured by the self-kindness scale of the SCS or its SOCS-S equivalent 'feeling for the person suffering' is particularly relevant as a buffer against emotional problems.
Conclusion:
The protective nature of self-compassion can be established by both measures. Caution is advised with the use of the uncompassionate self-responding scales included in the SCS-Y as they appear to measure vulnerability rather than protection.
Alexithymia has an important effect on learning burnout; however, the underlying mechanism of this relation remains unclear. This study aims to examine why alexithymia is related to increased learning burnout. Here, we investigated associations between alexithymia and learning burnout, as well as the potential mediating role of self-compassion in a sample of 466 Chinese children and adolescents from primary and secondary schools. Mediation analysis showed that higher alexithymia was significantly associated with greater learning burnout, and this relationship was mediated by self-compassion. Findings suggest that promoting self-compassion may mitigate the adverse effects of alexithymia on learning burnout.
Background
Breast cancer has a high incidence rate, emphasizing the necessity of enhanced information on health-related quality of life (HrQOL) in this population of patients. The aim of this study was to identify the factors influencing the QOL experienced by patients in Pakistan.
Methods
A cross-sectional study was conducted on women with breast cancer, and four instruments were used on a random sample of 130 Pakistani women: FACIT-B Version 4 questionnaire,WHO causality assessment scale, Naranjo’s algorithm, and a demographic/clinical characteristics section. Data analysis included descriptive analysis, independent sample t-test, and analysis of variance (ANOVA) test.
Results
The patients’ mean age was 49.10 (standard deviation (SD) 10.89); 98.5% were married. The mean score was 18.34 for physical wellbeing (SD 5.92; interquartile range (IQR) 11), 16.33 for social/family wellbeing (SD 6.3; IQR 11.25), 13.6 for emotional wellbeing (SD 3.55; IQR 6), 17.13 for functional wellbeing (SD 3.73; IQR 6), and 24.86 for breast cancer subscale (SD 3.64; IQR 4). The study found that the age, entitlement, recurrence, marital status, salary, number of doses, duration of cancer treatment, and chemotherapy sessions were significantly related to QOL terms in the assessment of the FACIT-B scale. The WHO causality evaluation scale determined that 78.1% of the responses were “probable” and 20.1% were “possible”. According to Naranjo’s algorithm assessment scale, 80% of adverse drug reactions (ADRs) were “probable”, whereas 18.4% were declared “possible”. Chemotherapy-induced anemia was the most often reported ADR in 64.6% of patients, followed by chemotherapy-induced nausea and vomiting (61.5%).
Conclusion
Healthcare practitioners must acknowledge and take into account the significance of QOL in addition to therapy for breast cancer patients in order to enhance their health. The findings of this study will aid in filling gaps in current unknown knowledge and identifying sites where patients require additional assistance. Because cancer and chemotherapy clearly have a negative impact on individuals’ QOL, oncologists must concentrate on strategies that help cancer patients during their sickness and treatment while also enhancing self-care and QOL. Those with cancer will benefit from emotional wellbeing and adaptation to their disease.
Compassion fatigue is a common complication in nurses, which can lead to burnout, job dissatisfaction, and a decline in the quality of patient care. This study aimed to investigate the impact of loving-kindness meditation on compassion fatigue of nurses working in the neonatal intensive care unit (NICU). This cluster-blinded randomized clinical trial study was conducted on 66 NICU nurses in 2 educational hospitals selected. The intervention group received a 1-month online program for daily training and practice of loving-kindness meditation. The control group received miscellaneous files on mental health during the COVID-19 pandemic period. The Nursing Compassion Fatigue Inventory (NCFI) was filled out by the 2 groups, before and after the intervention. The results showed that the mean scores of the NCFI in the intervention group decreased significantly compared with before the intervention (P = .002). In comparison with the control group, there was a significant difference between the mean scores of the 2 groups after the intervention (P = .034). Among nurses working in NICU, loving-kindness meditation significantly reduces compassion fatigue after 1 month. These findings support the use of this intervention for nurses.
Objectives:
Physicians and medical students are subject to higher levels of psychological distress than the general population. These challenges have a negative impact in medical practice, leading to uncompassionate care. This pilot study aims to examine the feasibility of Compassion Cultivation Training (CCT) to reduce psychological distress and improve the well-being of medical students. We hypothesize that the CCT program, as compared to a waitlist control group, will reduce psychological distress (i.e., stress, anxiety, and depression) and burnout symptoms, while improving compassion, empathy, mindfulness, resilience, psychological well-being, and emotion-regulation strategies after the intervention. Furthermore, we hypothesize that these improvements will be maintained at a two-month follow-up.
Methods:
Medical students were randomly assigned to an 8-week CCT or a Waitlist control group (WL). They completed self-report assessments at pre-intervention, post-intervention, and a 2-month follow-up. The outcomes measured were compassion, empathy, mindfulness, well-being, resilience, emotional regulation, psychological distress, burnout, and COVID-19 concern. Mixed-effects models and Reliable Change Index were computed.
Results:
Compared with WL, CCT showed significant improvements in self-compassion, mindfulness, and emotion regulation, as well as a significant decrease in stress, anxiety, and emotional exhaustion component of burnout. Furthermore, some of these effects persisted at follow-up. No adverse effects of meditation practices were found.
Conclusions:
CCT enhanced compassion skills while reducing psychological distress in medical students, this being critical to preserving the mental health of physicians while promoting compassionate care for patients. The need for institutions to include this type of training is also discussed.
Background:
People with mental disorders face frequent stigmatizing attitudes and behaviors from others. Importantly, they can internalize such negative attitudes and thus self-stigmatize. Self-stigma is involved in diminished coping skills leading to social avoidance and difficulties in adhering to care. Reducing self-stigma and its emotional corollary, shame, is thus crucial to attenuate the negative outcomes associated with mental illness. Compassion Focused Therapy (CFT) is a third wave cognitive behavioral therapy that targets shame reduction and hostile self-to-self relationship and allows for symptom improvement while increasing self-compassion. Although shame is a prominent part of the concept of self-stigma, the efficacy of CFT has never been evaluated in individuals with high levels of self-stigma. The purpose of this study is to evaluate the efficacy and acceptability of a group-based CFT program on self-stigma, compared to a psychoeducation program for self-stigma (Ending Self-Stigma) and to treatment as usual (TAU). We hypothesize that diminished shame and emotional dysregulation and increased self-compassion will mediate the relationship between self-stigma improvements post-therapy in the experimental group.
Methods:
This seven-center trial will involve 336 participants diagnosed with a severe mental illness and reporting high levels of self-stigma. Participants will be randomized into one of three treatment arms: 12 week-treatment of Compassion-Focused Therapy (experimental arm), 12 week-treatment of Psychoeducation (active control arm), and TAU (treatment as usual - passive control arm). The primary outcome is the decrease of self-stigma scores on a self-report scale, i.e., ISMI, at 12 weeks.
Secondary endpoints include sustainability of self-stigma scores (ISMI) and self-reported scores regarding target psychological dimensions, e.g., shame and emotional regulation, social functioning and psychiatric symptoms. Assessments are scheduled at pretreatment, post-treatment (at 12 weeks), and at 6-month follow-up. Acceptability will be evaluated via (i) the Credibility and Expectancy Questionnaire at T0, the Consumer Satisfaction Questionnaire for Psychotherapeutic Services posttreatment and at 6-month follow-up, (iii) attendance and (iv) dropout rates.
Discussion:
This study will evaluate the potential efficacy and acceptability of a group-based CFT program on the decrease of self-stigma, and thereby contribute to the continuing development of evidence-based therapeutic interventions for the internalized stigma of mental disorders. `
Trial registration:
This trial has been registered on January 26, 2023: clinicaltrials.gov NCT05698589 https://www.clinicaltrials.gov/ct2/show/NCT05698589
Research has gradually demonstrated that mindfulness-based interventions (MBIs) considerably improve the well-being of people with psychosis. However, the maintenance of these outcomes in the long term and the continuity of mindfulness practices in the transition from research to clinical contexts remain practically unexplored. Also, researchers have paid little attention to the movement of MBIs to compassion training and to how these approaches can complement one another. This clinical case study seeks to analyse the experience of a young woman with first-episode schizophrenia. The patient participated in an MBI for psychosis within the context of a research project, after which she received both individual and group clinical treatment, including compassion-focused therapy (CFT) training. The following aspects were measured at baseline, after the intervention, and at three-, nine-, twelve-, and forty-four-month follow-up: general symptomatology (DASS-21), worry (PSWQ-11), affect (PANAS), self-esteem (Rosenberg Scale), well-being (Ryff Scales), and mindfulness (FFMQ). Qualitative patient data were also recorded. Results show that the patient’s well-being improved after the MBI. Clinical observations show that, when the psychotic symptomatology had entered a second acute phase, the patient was better prepared to deal with the situation by using CFT skills instead of mindfulness. The applicability of MBIs and CFT is discussed considering the patient’s specific symptoms and the course of her disease within research settings and in clinical practice.KeywordsPsychosisMindfulnessCompassionClinical caseEarly intervention
Compassion Focused Therapy (CFT) was developed by Paul Gilbert to target self-criticism and shame which underpin many clinical disorders. At its core, CFT is an integrated and evolutionary-informed biopsychosocial and contextual model of therapy. It is a form of therapy that has been used with a range of different clinical populations, including eating disorders, trauma, personality disorders, bipolar, anxiety, and depression. The aim of this chapter is to describe the origins of CFT, the definition of compassion used by CFT, and how CFT is proposed to work by targeting specific psychological and physiological processes. In this chapter, we will also describe compassionate mind training, which is a time-limited skills-based programme aimed to address self-criticism and shame. Finally, the chapter will introduce a case formulation of CFT, as well as a new 12 module protocol of CFT, providing an overview of session content.KeywordsCompassion-focused therapyCompassionate mind trainingSocial mentality theoryPsychotherapyIntervention science
As demonstrated by the chapters in this Handbook, self-compassion is associated with myriad benefits for mental health and psychological well-being. The beneficial impact of self-compassion is perhaps even more evident in psychotherapy, where self-compassion has long held a role under the umbrella of “self-acceptance.” Drawing primarily on compassion-focused therapy and the mindful self-compassion program, this chapter provides guidance on how to integrate self-compassion into psychotherapy and provides and overview of the evidence connecting self-compassion with therapeutic processes and outcomes.The chapter begins by locating self-compassion in the context of psychotherapy, past and present. Next, we outline the evidence for self-compassion as a transdiagnostic and transtheoretical mechanism of action in therapy. The majority of this chapter describes three levels by which self-compassion can be integrated into psychotherapy—compassionate presence, compassionate relationship, and compassionate interventions—along with supporting research. When all three levels are part of treatment, it can be considered fully self-compassion based. Finally, we explore emotion regulation as the basic mechanism by which self-compassion works in psychotherapy, along with underlying neurophysiological and psychological processes, especially the cultivation of secure attachment and the alleviation of shame.KeywordsSelf-compassionPsychotherapyTherapeutic relationshipTherapeutic allianceEmotion regulation
Background: Emotional processing and destructive lifestyle are among the components that impact drug abuse; However, interventions for improving the emotional processing and lifestyle of addicts have received less consideration. Therefore, considering the mechanism of the impact of compassion-based therapy and its effectiveness on the component's risk of recurrence, might this intervention be effective on the lifestyle and emotional processing of addicts?
Aims: The aim of the present study was to the effectiveness of compassion therapy intervention on the lifestyle and emotional processing of addicts in the non-drug rehabilitation phase.
Methods: The quasi-experimental research design was pretest-posttest and follow-up with the control group. The statistical population of this study included all addicts who had received a diagnosis of opioid dependence in 2021 at addiction treatment clinics in Urmia. The sample size consisted of 30 Subjects of adolescents (15 in the experimental group and 15 in the control group). The statistical population was selected by the available sampling method and placed in two groups. The compassion therapy intervention was implemented for the experimental group, while the control group did not receive any intervention. The research instruments included the Lifestyle Scale (Lali et al., 2012) and the Emotional Processing Scale (Backer et al., 2007). Finally, Data were analyzed using the Repeated Measures ANOVA.
Results: The results showed that compassion therapy intervention had a significant effect on lifestyle components and emotional processing (P< 0.001). So that the scores of physical health, exercise and fitness, weight control and nutrition, disease prevention, psychological health, spiritual health, social health, drug avoidance, accident prevention, and environmental health increase, and scores of suppression, Lack of emotional experience, symptoms of lack of emotional processing, lack of emotion regulation and avoidance had a significant decrease in the post-test phase and the change in scores in the follow-up phase was stable.
Conclusion: According to the results, it might be concluded that compassion therapy intervention improves lifestyle (Physical and psychological health, daily activities, and diet) and emotional processing (Management and processing of emotional information) in addicts in the non-drug rehabilitation phase.
Background:
Insecure adult attachment, shame, self-blame, and isolation following perinatal loss place bereaved women at risk of adverse psychological outcomes, which can impact child and family outcomes. To date, no research has considered how these variables continue to influence women's psychological health in pregnancy subsequent to loss.
Objective:
This study explored associations between prenatal psychological adjustment (less grief and distress) and adult attachment, shame, and social connectedness, in women pregnant after loss.
Method:
Twenty-nine pregnant Australian women accessing a Pregnancy After Loss Clinic (PALC) completed measures of attachment styles, shame, self-blame, social connectedness, perinatal grief, and psychological distress.
Results:
Four 2-step hierarchical multiple regression analyses revealed adult attachment (secure/avoidant/anxious; Step 1), shame, self-blame, and social connectedness (Step 2) explained 74% difficulty coping, 74% total grief, 65% despair, and 57% active grief. Avoidant attachment predicted more difficulty coping and higher levels of despair. Self-blame predicted more active grief, difficulty coping, and despair. Social connectedness predicted lower active grief, and significantly mediated relationships between perinatal grief and all three attachment patterns (secure/avoidant/anxious).
Conclusions:
Although avoidant attachment and self-blame can heighten grief in pregnancy after loss, focusing on social connectedness may be a helpful way for prenatal clinicians to support pregnant women during their subsequent pregnancy - and in grief.
Emotion socialization is a fundamental process for adolescent's psychological functioning, yet multiple socialization agents have rarely been examined simultaneously. We tested emotion regulation (ER) as a mediator and friend supportive emotion socialization as a moderator on the relation between parent unsupportive emotion socialization and adolescent internalizing symptoms. Participants were 132 adolescents (Mage = 16.30 years, 53.0% girls, 80.3% White) and a parent. We used a multi-method (observation, questionnaires) and multi-informant (parent, adolescent) approach. Parent unsupportive emotion socialization was linked to poorer sadness/worry and anger regulation. Friend supportive sadness/worry and anger socialization were related to fewer internalizing symptoms. Regarding moderation effects, at low levels of sadness/worry friend socialization, the link between sadness/worry regulation and internalizing symptoms was strongest, although also significant at medium and high levels of friend support. Both type of emotion and socialization agent are important to consider when understanding associations with internalizing symptoms.
In ‘The Great Discourse on the Establishing of Mindfulness’, the Buddha mentioned “There is this one way for the purification of beings, for overcoming sorrow and lamentation, for extinguishing of stress and suffering, for attaining to higher knowledge, and for the realisation of liberation” (Digha Nikaya 22). This ‘one way’ is the application of mindfulness meditation on body, feelings, mind, and phenomena. Such wisdom words of an enlightened teacher uttered more than 2,500 years ago are timeless truths which modern science has just begun to uncover.
For four decades since Jon Kabat-Zinn founded the Stress Reduction Clinic at the University of Massachusetts Medical School to introduce the structured practice of mindfulness, the interest in mindfulness and other forms of meditation has grown exponentially. Meditation is no longer merely a spiritual quest practised at secluded religious centres but a mainstream mind-body therapy for health and wellbeing. Meditation classes are everywhere: hospitals, mental health clinics, nursing homes, the military, correctional centres, sports centres, universities, schools, and even in nurseries. Research has played a pivotal role to usher in this newfound interest in meditation. There is growing evidence supporting the health benefits of meditation in reducing stress, managing pain, enhancing cognition, improving resilience, cultivating positive emotions, and much more. However, cumulative knowledge on the study of meditation from various research disciplines including neuroscience, psychophysiology, cognitive science, mental health and public health represent only the tip of the iceberg. There is still much to discover from these ancient mind and body practices.
This book is a compilation of recent research in the field of meditation. It provides a snapshot of exciting findings and developments such as the launch of a large-scale UK study to operationalise mindfulness in the mental health system, the possibility that Zen meditation can slow down cardiopulmonary ageing, a theoretical framework for describing meditation interventions in health research, the potential for meditation to address health inequality, the use of mindful self-compassion to enhance the wellbeing of adult learners, and the case study of a clinical psychologist and meditation teacher sharing her first-hand experience of living with spondylolisthesis in relative peace through applying mindfulness strategies. The included articles further contribute to our understanding of the role of meditation in health, defined by the World Health Organization as “not merely the absence of disease or infirmity, but a state of complete physical, mental and social wellbeing”.
It is an honour to be academic editors for this Special Issue and a great pleasure to review many insightful manuscripts first-hand. We wish to thank the publisher for this excellent opportunity to serve the research community. We are also grateful for the hard work and support provided by the editorial office to make this project a success. To all the authors, thank you for your contributions. To the readers, thank you for your interest. A plethora of quality works from the latest meditation research await in the following pages. May you gain many useful insights!
Background
It is well-recognized that early parenting significantly influences the health and well-being of children. However, many parents struggle with the daily demands of being a parent and feel overwhelmed and exhausted psychologically and physically. Encouraging self-care practices is essential for parents, and self-compassion may be a potential strategy to utilize.
Objectives
The review aims to assess the influence and impact of providing self-compassion education for parents and families when caring for their children.
Methods
This systematic review utilized Joanna Briggs Institute (JBI) methodology. A three-stage search approach was undertaken that included seven electronic databases, registries and websites. These databases are Medline, Embase, PsycINFO, Emcare, Cochrane library, Scopus, and ProQuest. The included studies were appraised using the standardized critical appraisal instruments for evidence of effectiveness developed by JBI.
Results
Ten studies met the inclusion criteria. Overall, the studies confirmed improved psychological well-being, and higher levels of self-compassion, kindness towards oneself and others, and mindfulness were reported. In addition, there were improvements in psychological well-being, decreased parental distress and perceived distress, lower levels of anxiety, and avoidance of negative experiences.
Conclusion
The findings provide evidence to guide further research on developing, designing, facilitating, and evaluating self-compassion education programs and workshops for parents and families.
Compassion-focused therapy was developed by Paul Gilbert as a means of addressing psychological difficulties underpinned by shame and self-criticism. The model draws on social, neurophysiological and evolutionary theory (especially attachment theory) to seek to understand emotional regulation and our basic social motivational systems. It postulates the benefit of mindfully developing compassion, thus activating our ‘affiliative/soothing system’, to balance our affect regulating systems, particularly in response to threat. In recent years there has been a growing evidence base for the approach, and the application of compassion- based initiatives has been used with NHS staff teams, the armed forces, business settings and within education. Compassion-based approaches within education settings offer a potential means of generating greater psychological well-being for students, staff, parents and the wider community whilst also protecting and enhancing the priorities of the settings in which they are applied. Thus they represent an intervention which is systemic and universal. This paper provides an overview of compassion-focused therapy together with examples of how compassion-based initiatives are carried out in contexts of relevance to the work of educational psychologists.
Keywords: Compassion; compassion-focused therapy; mindfulness.
Most forms of psychological distress encompass both the relation to the self in the form of shame and self-criticism, as well as the relation to others in the form of distance and isolation. These are often longstanding and pervasive problems that permeate a wide range of psychological disorders and are difficult to treat. This paper focuses on how problems with shame and self-criticism can be addressed using compassion focused therapy (CFT). In a pilot study we tested the effectiveness of CFT with a single case experimental design in six individuals suffering from social anxiety. The aim was to establish whether CFT lead to increases in self-compassion, and reductions in shame, self-criticism and social anxiety. Moreover, the aim was to investigate to what extent participants were satisfied and experienced CFT as helpful in coping with social anxiety and in increasing self-compassion. Taken together the preliminary results show that CFT is a promising approach. CFT was effective for 3 of 6 participants, probably effective for 1 of 6 and more questionably effective for 2 of 6 participants. These results add to the empirical evidence that CFT is a promising approach to address problems with self-compassion. This research body is as of yet small, and more studies are needed.
The importance of compassion is widely recognized and it is receiving increasing research attention. Yet, there is lack of consensus on definition and a paucity of psychometrically robust measures of this construct. Without an agreed definition and adequate measures, we cannot study compassion, measure compassion or evaluate whether interventions designed to enhance compassion are effective. In response, this paper proposes a definition of compassion and offers a systematic review of self- and observer-rated measures. Following consolidation of existing definitions, we propose that compassion consists of five elements: recognizing suffering, understanding the universality of human suffering, feeling for the person suffering, tolerating uncomfortable feelings, and motivation to act/acting to alleviate suffering. Three databases were searched (Web of Science, PsycInfo, and Medline) and nine measures included and rated for quality. Quality ratings ranged from 2 to 7 out of 14 with low ratings due to poor internal consistency for subscales, insufficient evidence for factor structure and/or failure to examine floor/ceiling effects, test-retest reliability, and discriminant validity. We call for empirical testing of our five-element definition, and if supported, the development of a measure of compassion based on this operational definition, which demonstrates adequate psychometric properties.
To date, there is no evidence suggesting that a program aimed at increasing self-compassion is effective in interdependent cultures such as Japan. The aim of this study was to examine the effects of an Enhancing Self-Compassion Program (ESP) among Japanese individuals in a randomized controlled study. Individuals reporting low self-compassion (N = 40) were randomly assigned to an ESP or wait-list control group. Participants completed self-report questionnaires at pretreatment, post-treatment, and a three-month follow-up. In the post-treatment and follow-up, ANOVAs revealed that the ESP group (N = 16) had significant improvements in each of the subscales of self-compassion (Cohen’s ds: .91–1.51) except for mindfulness, whereas the control group (N = 12) did not. Greater reductions in negative thoughts and emotions in the ESP group were also found. These gains remained at follow-up. These findings suggest that an ESP may be an effective and acceptable adjunct intervention for Japanese individuals with low self-compassion.
Recently, the Self-Compassion Scale (SCS) has been criticized for problems with psychometric validity. Further, the use of an overall self-compassion score that includes items representing the lack of self-compassion has been called into question. I argue that the SCS is consistent with my definition of self-compassion, which I see as a dynamic balance between the compassionate versus uncompassionate ways that individuals emotionally respond to pain and failure (with kindness or judgment), cognitively understand their predicament (as part of the human experience or as isolating), and pay attention to suffering (in a mindful or over-identified manner). A summary of new empirical evidence is provided using a bi-factor analysis, which indicates that at least 90 % of the reliable variance in SCS scores can be explained by an overall self-compassion factor in five different populations, justifying the use of a total scale score. Support for a six-factor structure to the SCS was also found; however, suggesting the scale can be used in a flexible manner depending on the interests of researchers. I also discuss the issue of whether a two-factor model of the SCS—which collapses self-kindness, common humanity, and mindfulness items into a “self-compassion” factor and self-judgment, isolation, and over-identification items into a “self-criticism” factor—makes theoretical sense. Finally, I present new data showing that self-compassion training increases scores on the positive SCS subscales and decreases scores on the negative subscales, supporting the idea that self-compassion represents more compassionate and fewer uncompassionate responses to suffering.
Mind wandering, or the tendency for attention to drift to task-irrelevant thoughts, has been associated with worse intra- and inter-personal functioning. Utilizing daily experience sampling with 51 adults during 9-weeks of a compassion meditation program, we examined effects on mind wandering (to neutral, pleasant, and unpleasant topics) and caring behaviors for oneself and others. Results indicated that compassion meditation decreased mind wandering to neutral topics and increased caring behaviors towards oneself. When collapsing across topics, mind wandering did not serve as an intermediary between the frequency of compassion meditation practice and caring behaviors, though mind wandering to pleasant and unpleasant topics was linked to both variables. A path analysis revealed that greater frequency of compassion meditation practice was related to reductions in mind wandering to unpleasant topics and increases in mind wandering to pleasant topics, both of which were related to increases in caring behaviors for oneself and others.
This case study examines the contribution of compassionate mind training (CMT) when used as a resource in the eye movement desensitization and reprocessing (EMDR) treatment of a 58-year-old man, who presented after a recent trauma with psychological distress and somatic symptoms—an
inability to sign his name. Self-report questionnaires (Hospital Anxiety and Depression Scale [HADS], Impact of Events Scale-R [IES-R], and Self-Compassion Scale [SCS]) were administered at pretherapy, midtherapy, posttherapy, and 9-month follow-up. EMDR with CMT facilitated recall of forgotten
memories about his sister's traumatic death decades previously, with related emotions of shame and grief, creating insight into how these past events linked to his current signature-signing phobia. Eight sessions of therapy resulted in an elimination of the client's signature-signing phobia
and a reduction in trauma-related symptoms, elevation in mood, and increase in self-compassion. Effects were maintained at 9-month follow-up. The "Discussion" section highlights the value of working collaboratively with clients to best meet their individual needs.
This study explored the benefits of a group-based compassion-focused therapy approach in a heterogeneous group of clients presenting with severe and enduring mental health difficulties to a community mental health team. Seven groups with an average of five clients per group were run over 12-14 weeks. The format of the group followed the procedures of explaining the evolutionary model, formulating client problems within the compassion-focused therapy model, introducing clients to the core practices of compassionate training, and using compassion based interventions to address core difficulties. Questionnaires were completed pre- and post intervention: Self-criticism, shame, depression, anxiety, and stress. Significant reductions were found for depression, anxiety, stress, self-criticism, shame, submissive behavior, and social comparison post intervention. Of importance, at pre-intervention the majority of patients were in the severe category of depression scores. At the end of therapy the majority were in the borderline category. A combination of self-report data and client feedback suggests that compassion focused therapy is easily understood, well-tolerated, seen as helpful and produces significant changes in objective measures of mental health difficulties in naturalistic settings.
Self-compassion has been shown to be related to several types of psychopathology, including traumatic stress, and has been shown to improve in response to various kinds of interventions. Current conceptualizations of self-compassion fit well with the psychological flexibility model, which underlies acceptance and commitment therapy (ACT). However, there has been no research on ACT interventions specifically aimed at self-compassion. This randomized trial therefore compared a 6-hour ACT-based workshop targeting self-compassion to a wait-list control. From pretreatment to 2-month follow-up, ACT was significantly superior to the control condition in self-compassion, general psychological distress, and anxiety. Process analyses revealed psychological flexibility to be a significant mediator of changes in self-compassion, general psychological distress, depression, anxiety, and stress. Exploratory moderation analyses revealed the intervention to be of more benefit in terms of depression, anxiety, and stress to those with greater trauma history.
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.
Background
People with acquired brain injuries (ABI) frequently experience psychological difficulties such as anxiety and depression, which may be underpinned and maintained by high self-criticism and shame alongside an inability to self-soothe. Compassionate focused therapy (CFT) was developed to address shame and self-criticism and foster the ability to self-soothe. Objectives
This is a naturalistic evaluation with the aim of assessing the feasibility, safety, and potential value of CFT for ABI patients with emotional difficulties receiving neuropsychological rehabilitation. Methods
This study employed a mixed methods design combining self-report measures and qualitative interviews. Twelve patients received a combination of CFT group and individual intervention. Self-report measures of self-criticism, self-reassurance, and symptoms of anxiety and depression were collected pre and post programme and analysed using Wilcoxon signed rank test (N=12; five female, seven males). Follow-up data were analysed in the same manner (N=9). Interviews were conducted with six patients and analysed using interpretative phenomenological analysis. ResultsCFT was associated with significant reductions in measures of self-criticism, anxiety, and depression and an increase in the ability to reassure the self. No adverse effects were reported. Three superordinate themes emerged from the interviews: psychological difficulties; developing trust and finding safeness; and a new approach. Conclusions
This study suggests that CFT is well accepted in ABI survivors within the context of neuropsychological rehabilitation. Furthermore, the results indicate that further research into CFT for psychological problems after ABI is needed and that there may be key aspects, which are specific to CFT intervention, which could reduce psychological difficulties after ABI.
Objective:
Kindness-based meditation (KBM) is a rubric covering meditation techniques developed to elicit kindness in a conscious way. Some techniques, for example, loving-kindness meditation and compassion meditation, have been included in programs aimed at improving health and well-being. Our aim was to systematically review and meta-analyze the evidence available from randomized controlled trials (RCTs) comparing the effects of KBM on health and well-being against passive and active control groups in patients and the general population.
Method:
Searches were completed in March 2013. Two reviewers applied predetermined eligibility criteria (RCTs, peer-reviewed publications, theses or conference proceedings, adult participants, KBM interventions) and extracted the data. Meta-analyses used random-effects models.
Results:
Twenty-two studies were included. KBM was moderately effective in decreasing self-reported depression (standard mean difference [Hedges's g] = -0.61, 95% confidence interval [CI] [-1.08, -0.14]) and increasing mindfulness (Hedges's g = 0.63, 95% CI [0.22, 1.05]), compassion (Hedges's g = 0.61, 95% CI [0.24, 0.99]) and self-compassion (Hedges's g = 0.45, 95% CI [0.15, 0.75]) against passive controls. Positive emotions were increased (Hedges's g = 0.42, 95% CI [0.10, 0.75]) against progressive relaxation. Exposure to KBM may initially be challenging for some people. RESULTS were inconclusive for some outcomes, in particular against active controls. The methodological quality of the reports was low to moderate. RESULTS suffered from imprecision due to wide CIs deriving from small studies.
Conclusions:
KBM showed evidence of benefits for the health of individuals and communities through its effects on well-being and social interaction. Further research including well-conducted large RCTs is warranted.
Compassion focused therapy (CFT) is rooted in an evolutionary, functional analysis of basic social motivational systems (e.g., to live in groups, form hierarchies and ranks, seek out sexual, partners help and share with alliances, and care for kin) and different functional emotional systems (e.g., to respond to threats, seek out resources, and for states of contentment/safeness). In addition, about 2 million years ago, (pre-)humans began to evolve a range of cognitive competencies for reasoning, reflection, anticipating, imagining, mentalizing, and creating a socially contextualized sense of self. These new competencies can cause major difficulties in the organization of (older) motivation and emotional systems. CFT suggests that our evolved brain is therefore potentially problematic because of its basic ‘design,’ being easily triggered into destructive behaviours and mental health problems (called ‘tricky brain’). However, mammals and especially humans have also evolved motives and emotions for affiliative, caring and altruistic behaviour that can organize our brain in such a way as to significantly offset our destructive potentials. CFT therefore highlights the importance of developing people's capacity to (mindfully) access, tolerate, and direct affiliative motives and emotions, for themselves and others, and cultivate inner compassion as a way for organizing our human ‘tricky brain’ in prosocial and mentally healthy ways.
Body dissatisfaction is a major source of suffering among women of all ages. One potential factor that could mitigate body dissatisfaction is self-compassion, a construct that is garnering increasing research attention due to its strong association with psychological health. This study investigated whether a brief 3-week period of self-compassion meditation training would improve body satisfaction in a multigenera-tional group of women. Participants were randomized either to the meditation intervention group (N=98; M age=38.42) or to a waitlist control group (N=130; M age=36.42). Results sug-gested that compared to the control group, intervention par-ticipants experienced significantly greater reductions in body dissatisfaction, body shame, and contingent self-worth based on appearance, as well as greater gains in self-compassion and body appreciation. All improvements were maintained when assessed 3 months later. Self-compassion meditation may be a useful and cost-effective means of improving body image in adult women.
Acquired brain injury (ABI) commonly results in a range of interacting difficulties including regulating emotion, managing social interactions and cognitive changes. Emotional adjustment to ABI can be difficult and requires adaptation of standard psychological therapies. This article outlines a case where cognitive– behavioural therapy (CBT) was of limited effectiveness but was significantly enhanced with compassion focused therapy (CFT). This article describes Jenny, a 23-year-old woman who suffered a traumatic brain injury 3 years prior to attending rehabilitation. Jenny presented with low self-esteem and mental health difficulties. Neuropsychological assessment revealed executive functioning difficulties. Jenny entered a holistic neuropsychological rehabilitation program aimed at improving complex interacting difficulties, receiving CBT as part of this. As CBT was of limited effectiveness, reformulation of Jenny's difficulties was presented to her based on CFT. The CFT intervention employed aimed to help Jenny develop self-validation and acceptance through producing feelings of kindness and warmth. Shifting the affective textures to the self is a key process for CFT. Self-report measures of mental health and self-esteem showed positive changes and the usefulness of CFT for Jenny. Adaptations in the context of Jenny's ABI are discussed. In conclusion, CFT may be useful in conceptualising emotional responses and developing intervention in rehabilitation after ABI, especially because CFT is based on a neurophysiological model of affect regulation that pays particular attention to the importance of affiliative emotions in the regulation of threat-focused emotion and self-construction.
Background:
People with personality disorders, especially those who also experience high self-criticism and shame, are known to be a therapeutic challenge and there is a high dropout rate from therapy. Compassion-focused therapy (CFT) was designed to address shame and self-criticism specifically, and to develop people's ability to be self-reassuring and more compassionate to themselves and others.
Aims:
This study explored how CFT affected self-criticism and self-attacking thoughts, feelings, and behaviours, as well as the general symptoms of anxiety, stress, and depression of a personality disordered group within an outpatient group setting, and evaluated the extent of maintenance at a 1-year follow-up. A secondary objective was to identify some of the key characteristics that such an intervention would require. This was a pilot study exploring the feasibility, acceptability, and potential value of CFT in treating this difficult population and, as such, was designed as a pre-randomized controlled trial (RCT) to provide evidence to support applications for funding for an RCT.
Methods and design:
This study utilized a mixed method combining qualitative and quantitative methods to support a programme evaluation. Eight participants were introduced to the evolutionary-based CFT model and taken through explorations of the nature of self-criticism and shame. In subsequent sessions, participants were taught the main compassion-focused exercises, and any difficulties were addressed. The group was asked to share their personal stories and experiences of practicing self-compassion and to develop compassionate encouragement for each other. Self-report measures were administered at the beginning, end, and at a 1-year follow-up.
Results:
This 16-week group therapy was associated with significant reductions in shame measured by the Others as Shamer Scale (OAS), social comparison on the Social Comparison Scale (SCS) feelings of hating oneself, and an increase in abilities to be self-reassuring on the Self-Attacking and Self-Reassuring Scale (FSCRS), depression and stress measured by the Depression Anxiety and Stress Scale (DASS). There were significant changes on all CORE variables, well-being, risk, functioning, and problems. Also interesting was that all variables showed a trend for continued improvement at 1-year follow-up, albeit statistically non-significant. A content analysis revealed that patients had found it a moving and very significant process in their efforts to develop emotional regulation and self-understanding.
Conclusion:
CFT, delivered in a routine psychotherapy department for personality disorders, revealed a beneficial impact on a range of outcome measures. These improvements were maintained and further changes noted at 1-year follow-up. Further research is needed to explore the benefits of CFT using more detailed analysis and RCTs.
Compassion focused therapy (CFT) was developed to stimulate capacities for soothing and affiliation to self and others as a way to regulate the threat system. This feasibility study aimed to assess the safety, the acceptability, the potential benefits, and associated change processes of using group CFT with people recovering from psychosis.
A prospective, randomized, open-label, blinded end point evaluation design was used.
Forty adult patients with a schizophrenia-spectrum disorder were randomized to CFT plus treatment as usual (TAU; n = 22) or to TAU alone (n = 18). Group CFT comprised 16 sessions (2 hr each, 1 x week). Participants were assessed prior to randomization and at the end of treatment. Assessments included semi-structured interviews to elicit narratives of recovery from psychosis and self-report measures. At the end of treatment, participants were rated on the Clinical Global Impression Scale. Narratives were coded using the Narrative Recovery Style Scale to provide measures of change in compassion and avoidance. Change processes were correlated with changes in depression, personal beliefs about illness, fear of recurrence, and positive and negative affect.
Group CFT was associated with no adverse events, low attrition (18%), and high acceptability. Relative to TAU, CFT was associated with greater observed clinical improvement (p < 0.001) and significant increases in compassion (p = 0.015) of large magnitude. Relative to TAU, increases in compassion in the CFT group were significantly associated with reductions in depression (p = 0.001) and in perceived social marginalization (p = 0.002).
Findings support the feasibility of group CFT in psychosis and suggest that changes in compassion can be achieved, which appear to reduce depression in particular. This is the first randomized controlled evaluation of CFT.
Compassion focused therapy appears as a safe, acceptable, promising, and evolving intervention for promoting emotional recovery from psychosis.
Compared to the general population, youth in foster care experience multiple psychosocial difficulties due to exceptionally high rates of maltreatment. Many youth in care receive psychological and/or psychotropic treatment but not all require or are willing to accept that level of intervention. For many, a “mental health” approach feels pathologizing. Nevertheless, these youth have suffered maltreatment and interventions to improve their ability to cope with past trauma and their often uncertain present are clearly needed. Cognitively-Based Compassion Training (CBCT) provides an alternative perspective on suffering and can be framed as a wellness intervention that is appropriate for all humans. The present study examined whether a 6-week CBCT intervention would improve psychosocial functioning among adolescents in foster care. Seventy adolescents were randomized to CBCT (twice weekly) or a wait-list condition. Youth were assessed at baseline and after 6 weeks. Groups did not differ on measures of psychosocial functioning following training; however practice frequency was associated with increased hopefulness and a trend for a decrease in generalized anxiety. Qualitative results indicated that participants found CBCT useful for dealing with daily life stressors. Adolescents in care were willing to engage in CBCT. The majority reported CBCT was very helpful and almost all reported they would recommend CBCT to a friend. Participants reported specific instances of using CBCT strategies to regulate emotion, manage stress, or to respond more compassionately towards others. Standardized self-report measures were not sensitive to qualitative reports of improved functioning, suggesting the need for measures more sensitive to the positive changes noted or longer training periods to demonstrate effects. Practical issues surrounding implementation of such programs in high-risk youth populations are identified. Recommendations are provided for further development.
To identify molecular mechanisms underlying the prospective health advantages associated with psychological well-being, we analyzed leukocyte basal gene expression profiles in 80 healthy adults who were assessed for hedonic and eudaimonic well-being, as well as potentially confounded negative psychological and behavioral factors. Hedonic and eudaimonic well-being showed similar affective correlates but highly divergent transcriptome profiles. Peripheral blood mononuclear cells from people with high levels of hedonic well-being showed up-regulated expression of a stress-related conserved transcriptional response to adversity (CTRA) involving increased expression of proinflammatory genes and decreased expression of genes involved in antibody synthesis and type I IFN response. In contrast, high levels of eudaimonic well-being were associated with CTRA down-regulation. Promoter-based bioinformatics implicated distinct patterns of transcription factor activity in structuring the observed differences in gene expression associated with eudaimonic well-being (reduced NF-κB and AP-1 signaling and increased IRF and STAT signaling). Transcript origin analysis identified monocytes, plasmacytoid dendritic cells, and B lymphocytes as primary cellular mediators of these dynamics. The finding that hedonic and eudaimonic well-being engage distinct gene regulatory programs despite their similar effects on total well-being and depressive symptoms implies that the human genome may be more sensitive to qualitative variations in well-being than are our conscious affective experiences.
In this article, the authors explore compassion in work organizations. They discuss the prevalence and costs of pain in organizational life, and identify compassion as an important process that can occur in response to suffering. At the individual level, compassion takes place through three subprocesses: noticing another’s pain, experiencing an emotional reaction to the pain, and acting in response to the pain. The authors build on this framework to argue that organizational compassion exists when members of a system collectively notice, feel, and respond to pain experienced by members of that system. These processes become collective as features of an organization’s context legitimate them within the organization, propagate them among organizational members, and coordinate them across individuals.
Compassion is a positive orientation towards suffering that may be enhanced through compassion training and is thought to influence psychological functioning. However, the effects of compassion training on mindfulness, affect, and emotion regulation are not known. We conducted a randomized controlled trial in which 100 adults from the community were randomly assigned to either a 9-week compassion cultivation training (CCT) or a waitlist (WL) control condition. Participants completed self-report inventories that measured mindfulness, positive and negative affect, and emotion regulation. Compared to WL, CCT resulted in increased mindfulness and happiness, as well as decreased worry and emotional suppression. Within CCT, the amount of formal meditation practiced was related to reductions in worry and emotional suppression. These findings suggest that compassion cultivation training effects cognitive and emotion factors that support psychological flexible and adaptive functioning.
Compassion is a key motivator of altruistic behavior, but little is known about individuals' capacity to cultivate compassion through training. We examined whether compassion may be systematically trained by testing whether (a) short-term compassion training increases altruistic behavior and (b) individual differences in altruism are associated with training-induced changes in neural responses to suffering. In healthy adults, we found that compassion training increased altruistic redistribution of funds to a victim encountered outside of the training context. Furthermore, increased altruistic behavior after compassion training was associated with altered activation in brain regions implicated in social cognition and emotion regulation, including the inferior parietal cortex and dorsolateral prefrontal cortex (DLPFC), and in DLPFC connectivity with the nucleus accumbens. These results suggest that compassion can be cultivated with training and that greater altruistic behavior may emerge from increased engagement of neural systems implicated in understanding the suffering of other people, executive and emotional control, and reward processing.
Although empathy is crucial for successful social interactions, excessive sharing of others’ negative emotions may be maladaptive
and constitute a source of burnout. To investigate functional neural plasticity underlying the augmentation of empathy and
to test the counteracting potential of compassion, one group of participants was first trained in empathic resonance and subsequently
in compassion. In response to videos depicting human suffering, empathy training, but not memory training (control group),
increased negative affect and brain activations in anterior insula and anterior midcingulate cortex—brain regions previously
associated with empathy for pain. In contrast, subsequent compassion training could reverse the increase in negative effect
and, in contrast, augment self-reports of positive affect. In addition, compassion training increased activations in a non-overlapping
brain network spanning ventral striatum, pregenual anterior cingulate cortex and medial orbitofrontal cortex. We conclude
that training compassion may reflect a new coping strategy to overcome empathic distress and strengthen resilience.
Psychosocial interventions often aim to alleviate negative emotional states. However, there is growing interest in cultivating positive emotional states and qualities. One particular target is compassion, but it is not yet clear whether compassion can be trained. A community sample of 100 adults were randomly assigned to a 9-week compassion cultivation training (CCT) program (n = 60) or a waitlist control condition (n = 40). Before and after this 9-week period, participants completed self-report inventories that measured compassion for others, receiving compassion from others, and self-compassion. Compared to the waitlist control condition, CCT resulted in significant improvements in all three domains of compassion—compassion for others, receiving compassion from others, and self-compassion. The amount of formal meditation practiced during CCT was associated with increased compassion for others. Specific domains of compassion can be intentionally cultivated in a training program. These findings may have important implications for mental health and well-being.
The application of mindfulness and compassion to evidence-based parenting programs (EBPPs) offers a novel approach in enhancing nurturing family environments. The proposed framework offers an opportunity to re-focus behavioral parenting interventions from primarily reducing problematic behaviors to instead increasing pro-social caring behavior. This article aimed to extend the knowledge base on EBPPs by (a) reviewing the current role of EBPPs; (b) discussing the potential of mindfulness and compassion to enhance EBPPs; (c) reviewing current EBPPs that integrate mindfulness and compassion; and (d) providing recommendations for EBPPs in order to help enhance their impact on building nurturing family environments. © 2016 American Psychological Association. Published by Wiley Periodicals, Inc., on behalf of the American Psychological Association