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What is Compassion-Focused Therapy (CFT)?

By The Science of Mindfulness

Compassion-Focused Therapy (CFT)

Compassion-Focused Therapy, also known as CFT, was developed by Paul Gilbert for people whose mental health difficulties are closely linked to high shame and self-criticism1. It draws on evolutionary psychology, attachment theory, and neuroscience to explain why people can be harshly self-critical and why soothing, caring responses are often hard to access. Gilbert describes emotion as organized around three systems — one for threat, one for drive and achievement, and one for soothing and connection — and CFT aims to strengthen the soothing system so that people can face difficulty with warmth rather than attack2, 3. CFT is a clinical therapy that uses mindfulness as one of its building blocks, and is distinct from the training programs described elsewhere on this site, such as Mindful Self-Compassion (MSC).

Course Format: The core of CFT is compassionate mind training: practices such as soothing-rhythm breathing, compassionate imagery, and developing a compassionate “self” that can relate to one’s own difficulties with courage, wisdom, and kindness3. CFT is delivered one-to-one and in groups across a series of weekly sessions, and the length and structure vary by setting and by the needs of the client.

Instructor Requirements: CFT is practiced by licensed mental health professionals who have completed CFT-specific training. Training is offered by CFT organizations, including the Compassionate Mind Foundation, which Gilbert helped found.

Course Outcomes: An early systematic review of 14 studies, three of them randomized controlled trials, found that results were mostly favorable to CFT and that it seemed particularly helpful for people high in self-criticism. The authors concluded that CFT shows promise for mood disorders but that more large, high-quality trials are needed before it can be considered evidence-based practice1.

A broader meta-analysis of compassion-based interventions, covering 21 randomized controlled trials and 1,285 participants (not limited to CFT), found significant improvements in self-reported compassion (d = 0.55), self-compassion (d = 0.70), mindfulness (d = 0.54), depression (d = 0.64), anxiety (d = 0.49), psychological distress (d = 0.47), and well-being (d = 0.51). The authors cautioned that the evidence relies largely on small samples4.

Clinical Populations: CFT has been studied mainly in people with mood disorders and in those with high levels of shame and self-criticism1, and has been applied to a range of other difficulties in clinical practice.

Learn More: Gilbert’s paper on the origins and nature of CFT is the standard overview. For a structured training course in compassion, see Compassion Cultivation Training (CCT).

This page is for general education and is not medical advice. Please speak with a qualified health professional about treatment options.

References

  1. Leaviss, J., & Uttley, L. (2014). Psychotherapeutic benefits of compassion-focused therapy: an early systematic review. Psychological Medicine, 45(5), 927-945. https://doi.org/10.1017/s0033291714002141
  2. Gilbert, P. (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53(1), 6-41. https://doi.org/10.1111/bjc.12043
  3. Gilbert, P. (2010). Compassion focused therapy: Distinctive features. Routledge.
  4. Kirby, J. N., Tellegen, C. L., & Steindl, S. R. (2017). A Meta-Analysis of Compassion-Based Interventions: Current State of Knowledge and Future Directions. Behavior Therapy, 48(6), 778-792. https://doi.org/10.1016/j.beth.2017.06.003

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