The effectiveness of compassion focused therapy with clinical populations: A systematic review and meta-analysis

L A Millard; M W Wan; D M Smith; A Wittkowski

doi:10.1016/j.jad.2023.01.010

The effectiveness of compassion focused therapy with clinical populations: A systematic review and meta-analysis

J Affect Disord. 2023 Apr 1:326:168-192. doi: 10.1016/j.jad.2023.01.010. Epub 2023 Jan 14.

Authors

L A Millard¹, M W Wan², D M Smith², A Wittkowski³

Affiliations

¹ Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, UK.
² Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, UK; Manchester Academic Health Science Centre, UK.
³ Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, UK; Manchester Academic Health Science Centre, UK. Electronic address: anja.wittkowski@manchester.ac.uk.

PMID: 36649790
DOI: 10.1016/j.jad.2023.01.010

Abstract

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 74.88% 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.

Keywords: Compassionate; Compassionate mind; Psychological therapy; RCT; Self-compassion.

Publication types

Meta-Analysis
Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Empathy
Fear / psychology
Feeding and Eating Disorders*
Female
Humans
Psychotherapy, Group* / methods
Self-Assessment