Compassion Focused Therapy (CFT) is a system of

psychotherapy Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of Psychology, psychological methods, particularly when based on regular Conversation, personal interaction, to help a person change behavior, increase hap ...

developed by

Paul Gilbert Paul Brandon Gilbert (born November 6, 1966) is an American hard rock and heavy metal music, heavy metal guitarist. He is the co-founder of the band Mr. Big (American band), Mr. Big, and was also a member of Racer X (band), Racer X, with whom he ...

that integrates techniques from

cognitive behavioral therapy Cognitive behavioral therapy (CBT) is a form of psychotherapy that aims to reduce symptoms of various mental health conditions, primarily depression, PTSD, and anxiety disorders. Cognitive behavioral therapy focuses on challenging and chang ...

with concepts from

evolutionary psychology Evolutionary psychology is a theoretical approach in psychology that examines cognition and behavior from a modern evolutionary perspective. It seeks to identify human psychological adaptations with regard to the ancestral problems they evolved ...

social psychology Social psychology is the methodical study of how thoughts, feelings, and behaviors are influenced by the actual, imagined, or implied presence of others. Although studying many of the same substantive topics as its counterpart in the field ...

developmental psychology Developmental psychology is the scientific study of how and why humans grow, change, and adapt across the course of their lives. Originally concerned with infants and children, the field has expanded to include adolescence, adult development ...

, Buddhist psychology, and

neuroscience Neuroscience is the scientific study of the nervous system (the brain, spinal cord, and peripheral nervous system), its functions, and its disorders. It is a multidisciplinary science that combines physiology, anatomy, molecular biology, ...

. According to Gilbert, "One of its key concerns is to use compassionate mind training to help people develop and work with experiences of inner warmth, safeness and soothing, via

compassion Compassion is a social feeling that motivates people to go out of their way to relieve the physical, mental, or emotional pains of others and themselves. Compassion is sensitivity to the emotional aspects of the suffering of others. When based ...

and

self-compassion In psychology, self-compassion is extending compassion to one's self in instances of perceived inadequacy, failure, or general suffering. American psychologist Kristin Neff has defined self-compassion as being composed of three main elements – ...

Overview

A central therapeutic technique of CFT is compassionate mind training, which teaches the skills and attributes of

. Compassionate mind training helps transform problematic patterns of cognition and emotion related to

anxiety Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...

anger Anger, also known as wrath ( ; ) or rage (emotion), rage, is an intense emotional state involving a strong, uncomfortable and non-cooperative response to a perceived provocation, hurt, or threat. A person experiencing anger will often experie ...

shame Shame is an unpleasant self-conscious emotion often associated with negative self-evaluation; motivation to quit; and feelings of pain, exposure, distrust, powerlessness, and worthlessness. Definition Shame is a discrete, basic emotion, d ...

and

self-criticism Self-criticism involves how an individual evaluates oneself. Self-criticism in psychology is typically studied and discussed as a negative personality trait in which a person has a disrupted self-identity. The opposite of self-criticism would be ...

. Biological evolution forms the theoretical backbone of CFT. Humans have evolved with at least three primal types of emotion regulation system: the threat (protection) system, the drive (resource-seeking) system, and the soothing system. CFT emphasizes the links between cognitive patterns and these three emotion regulation systems. Through the use of techniques such as compassionate mind training and

(CBT), counseling clients can learn to manage each system more effectively and respond more appropriately to situations. Compassion Focused Therapy is especially appropriate for people who have high levels of shame and self-criticism and who have difficulty in feeling warmth toward, and being kind to, themselves or others. CFT can help such people learn to feel more safeness and warmth in their interactions with others and themselves. Numerous methods are used in CFT to develop a person's compassion. For example, people undergoing CFT are taught to understand compassion from the third person, before transferring these thought processes to themselves.

Core principles

CFT is largely built on the idea that the evolution of caring behavior has major regulatory and developmental functions. The central focus of CFT is to concentrate on helping clients relate to their difficulties in compassionate ways, as well as provide them with effective tools to work with challenging circumstances and emotions they encounter. CFT helps those learn tools to engage with their battles in accepting and encouraging ways, thereby aiding themselves to feel confident about accomplishing difficult tasks and dealing with challenging situations. This is facilitated by: * Developing a positive therapeutic relationship that facilitates the process of engaging with one's challenges and development of skills to deal with them. * Developing non-blaming compassionate understandings into the nature of suffering. * Developing the ability to experience and cultivate compassionate attributes. * Developing the feeling of compassion for others, being open to compassion from others, and developing self-compassion. According to evolutionary analysis, there are three types of functional emotion regulation systems: drive, safety and threat. CFT is based on the relationship and interactions between these systems. One is born with each system but our surroundings implicate whether one utilizes and sustains the non-survival-based systems (drive and caregiving). * Threat and self-protection focused system: evolved to alert and direct attention to detect and respond to threats. This system contains threat-based emotions (anger, anxiety, disgust), and threat-based behaviors (fight/flight, freezing). * Drive, seeking and acquisition focused system: pay attention and notice advantageous resources, experience drive and pleasure in securing them (positive system is activating). * Contentment, soothing and affiliative system: enables state of peacefulness when individuals are no longer focused on threats or seeking out resources (allows body to rest and digest and have open attention). Using CFT enriches the compassion-based soothing system, while withdrawing from the threat-focused emotional regulation system. In turn, this will augment the ability to activate (drive) and work towards valued goals.

Applications

Compassion Focused Therapy has been investigated as a novel treatment for a wide variety of psychological disorders. A 2012 randomized controlled trial showed CFT to be a safe and clinically effective treatment option for psychosis patients. CFT was shown to be more effective than "treatment as usual", with particular efficacy in reducing depression symptoms. A further 2015 literature review of 14 different studies showed promising psychotherapeutic benefits of CFT, especially when treating mood disorders. A recent meta analysis found good support for CFT as a treatment for a variety of psychological difficulties. However, further large-scale trials are necessary in order for CFT to become an accepted, "evidence-based" treatment for these disorders. For cancer patients, compassion-based interventions including CFT was shown to relieve depression and elevate self-compassion in this population. CFT has also been explored as a treatment for individuals with eating disorders. This slightly modified version of CFT, CFT-E, has had promising results in treating adult outpatients with restrictive eating disorders as well as with binging and purging disorders. A 2014 literature review found CFT-E to be a particularly effective treatment for eating disorders due to the fact that it confronts the "high levels of shame and self‐criticism" that patients often experience. More recent primary studies have further proved CFT-E to be a safe and effective intervention for eating disorders. CFT is also being studied as a rehabilitation method for patients with acquired brain injuries (ABI). Preliminary, small-scale studies have shown CFT to be safe and beneficial in treating anxiety and depressive symptoms of ABI patients, although further large-scale studies are needed. As well as being a psychological therapy (for individuals and groups), Compassionate Mind Training (CMT) has been shown to be an effective approach for reducing psychological distress in the general public. A variety of studies have found that engaging in guided audios, online courses, an 8 week group and using an app (The Self-Compassion App) can lead to reductions in self-criticism, shame, attachment insecurity, depression and anxiety symptoms, as well as increasing self-compassion, positive emotions and wellbeing. CMT has also been used as an effective approach in schools, with results suggesting a variety of benefits for teachers who engaged in an 8 week compassion training course.

Limitations

Beaumont and Hollins Martin (2015) examined narrative reviews of 12 research findings that has shown use of CFT to treat and experiment with psychological outcomes in clinical populations. The researchers found that overall, there are improvements of mental health issues with CFT intervention, especially when combined with approaches such as cognitive behavioral therapy (CBT). Beaumont and Hollins Martin (2015) found a major limitation in the empirical studies are the small number of participants involved in each case. For instance, Gilbert and Proctor (2006) showed small reductions in depression, anxiety, self-criticism and shame, however their participant group involved only 6 members. The small number of participants can cause bias or facilitate a problem of generalization for the broader population. For instance, out of the twelve studies only two individually supported effectiveness of CFT. A study conducted by Lucre and Corten (2012) found CFT to be effective for treating patients with personality disorders, and another study by Heriot-Maitland et al. (2014) found that treating clients in acute inpatient settings was effective.

Recommendations

The findings of Beaumont and Hollins Martin (2015) recommended that the effectiveness of CFT needs further extensive research in order to fully examine reductions in mental illnesses and overall improvements in quality of life. This study recommends for consideration of larger samples of participants in order to ensure that CFT can be independently effective without other psychotherapy interventions involved such as CBT.

References

{{Psychotherapy Cognitive therapy Cognitive behavioral therapy Compassion