Skip to main content Accessibility help

Compassion-focused therapy with children and adolescents

  • Carlos Carona, Daniel Rijo, Céu Salvador, Paula Castilho and Paul Gilbert...


Compassion-focused therapy (CFT) is embedded in an evolutionary, functional analysis of psychopathology, with a focus on affiliative, caring and compassion processes. CFT has been applied in a number of adult settings, but its clinical applications in child and adolescent psychopathology and psychotherapy have not been systematically explored. This article describes the applications of CFT in paediatric populations. Specifically, the following developmental considerations are discussed: the unique importance of parent-child and attachment relationships for the development of self-compassion, being open to compassion from others and being compassionate to others; the potential effect of com passion training on the maturing brain (affective regulation systems); and the therapeutic targeting of shame and self-criticism to alleviate psychological distress and enhance the effectiveness of cognitive-behavioural interventions.

Learning Objectives

• Understand and differentiate the three affect regulation systems and their links to different forms of child and adolescent psychopathology

• Recognise the main components of compassionate mind training with children and adolescents, and related specific therapeutic strategies and exercises

• Acknowledge the importance of adopting a parent-child approach in CFT

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Compassion-focused therapy with children and adolescents
      Available formats

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Compassion-focused therapy with children and adolescents
      Available formats

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Compassion-focused therapy with children and adolescents
      Available formats


Corresponding author

Correspondence Dr Carlos Carona, University of Coimbra, Faculty of Psychology and Education Sciences, Cognitive and Behavioural Center for Research and Intervention, Rua do Colégio Novo, 3000–115 Coimbra, Portugal. Email:


Hide All

Declaration of Interest




Hide All
Addis, ME, Carpenter, KM (2000) The treatment rationale in cognitive-behavioral therapy: psychological mechanisms and clinical guidelines. Cognitive and Behavioral Practice, 7: 147–56.
Aknin, LB, Hamlin, JK, Dunn, EW (2012) Giving leads to happiness in young children. PLoS ONE, 7: e39211.
Baldwin, DA (1997) The concept of security. Review of International Studies, 23: 526.
Barish, K (2009) Emotions in Child Psychotherapy: An Integrative Framework. Oxford University Press.
Berg, I, Steiner, T (2003) Children's Solution Work. W. W. Norton & Company.
Bluth, K, Blanton, PW (2014) Mindfulness and self-compassion: exploring pathways to adolescent emotional well-being. Journal of Child and Family Studies, 23: 1298–309.
Bluth, K, Blanton, PW (2015) The influence of self-compassion on emotional well-being among early and older adolescent males and females. Journal of Positive Psychology, 10: 219–30.
Bowlby, J (1980) Loss: Sadness and Depression. Vol. 3: Attachment and Loss. Hogarth Press.
Brown, SL, Brown, RM (2015) Connecting prosocial behavior to improved physical health: contributions from the neurobiology of parenting. Neuroscience & Biobehavioral Reviews, 55: 117.
Carona, C, Moreira, H, Silva, N (2016) Therapeutic applications of mindfulness in paediatric settings. Advances in Psychiatric Treatment, 22: 1624.
Castilho, P, Pinto-Gouveia, J, Amaral, V, et al (2014) Recall of threat and submissiveness in childhood and psychopathology: the mediator effect of self-criticism. Clinical Psychology and Psychotherapy, 21: 7381.
Castilho, P, Pinto-Gouveia, J, Duarte, J (2015) Exploring self-criticism: confirmatory factor analysis of the FSCRS in clinical and nonclinical samples. Clinical Psychology and Psychotherapy, 22: 153–64.
Cozolino, L (2007) The Neuroscience of Human Relationships: Attachment and the Developing Brain. Norton.
Crocker, J, Canevello, A (2012) Consequences of self-image and compassionate goals. In Advances in Experimental Social Psychology (eds Devine, P, Plant, A.): 229–77. Academic Press.
Depue, RA, Morrone-Strupinsky, JV (2005) A neurobehavioral model of affiliative bonding. Behavioral and Brain Sciences, 28: 313–95.
Duncan, LG, Coatsworth, JD, Greenberg, MT (2009) A model of mindful parenting: implications for parent-child relationships and prevention research. Clinical Child and Family Psychology Review, 12: 255–70.
Eisenberg, N, Mussen, PH (1989) The Roots of Prosocial Behavior in Children. Cambridge University Press.
Fredrickson, BL, Grewen, KM, Coffey, KA, et al (2013) A functional genomic perspective on human well-being. Proceedings of the National Academy of Sciences, 110: 13684–9.
Gerhardt, S (2004) Why Love Matters: How Affection Shapes a Baby's Brain. Brunner-Routledge.
Gilbert, P, Irons, C (2005) Focused therapies and compassionate mind training for shame and self-attacking. In Compassion: Conceptualizations, Research and Use in Psychotherapy (ed Gilbert, P): 263325. Routledge.
Gilbert, P (2007) The evolution of shame as a marker for relationship security. In The Self-Conscious Emotions: Theory and Research (eds Tracy, JL, Robins, RW, Tangney, JP): 283309. Guilford Press.
Gilbert, P, McEwan, K, Mitra, R, et al (2008a) Feeling safe and content: a specific affect regulation system? Relationship to depression, anxiety, stress and self-criticism. Journal of Positive Psychology, 3: 182–91.
Gilbert, P, Irons, C (2008b) Shame, self-criticism, and self-compassion in adolescence. In Adolescent Emotional Development and the Emergence of Depressive Disorders (eds Allen, NB, Sheeber, LB): 195214. Cambridge University Press.
Gilbert, P (2009) Introducing compassion-focused therapy. BJPsych Advances, 15: 199208.
Gilbert, P (2010) Compassion Focused Therapy. Distinctive Features. Routledge.
Gilbert, P (2013) The Compassionate Mind. Constable Robinson.
Gilbert, P (2014) The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53: 641.
Gold, J, Sullivan, MW, Lewis, M (2011) The relation between abuse and violent delinquency: the conversion of shame to blame in juvenile offenders. Child Abuse and Neglect, 35: 459–67.
Greenland, SK (2010) The Mindful Child: How to Help Your Kid Manage Stress and Become Happier, Kinder, and More Compassionate. Free Press.
Hay, DF (1994) Prosocial development. Journal of Child Psychology and Psychiatry, 33: 2971.
Hoffmann, SG, Grossman, P, Hinton, DE (2011) Loving-kindness and compassion meditation: potential for psychological intervention. Clinical Psychology Review, 13: 1126–32.
Hutcherson, CA, Seppala, EM, Gross, JJ (2008) Loving-kindness meditation increases social connectedness. Emotion, 8: 720–4.
Jongsma, AE, Peterson, LM, McInnis, WP, et al (2006) The Child Psychotherapy Treatment Planner. John Wiley & Sons.
Joseph, GE, Strain, PS (2003) Enhancing emotional vocabulary in young children. Young Exceptional Children, 6: 1826.
Kabat-Zinn, J (1994) Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. Hyperion.
Kabat-Zinn, J (2003) Mindfulness-based interventions in context: past, present, and future. Clinical Psychology: Science and Practice, 10: 144–56.
Keltner, D, Kogan, A, Piff, PK, et al (2014) The sociocultural appraisals, values, and emotions (SAVE) framework of prosociality: core processes from gene to meme. Annual Review of Psychology, 65: 425–60.
Kirby, JN (2016) Compassion interventions: the programmes, the evidence, and implications for research and practice. Psychology & Psychotherapy, doi: 10.1111/papt.12104.
Klimecki, OM, Leiberg, S, Ricard, M, et al (2014) Differential pattern of functional brain plasticity after compassion and empathy training. Social Cognitive and Affective Neuroscience, 9: 873–9.
Layous, K, Nelson, SK, Oberle, E, et al (2012) Kindness counts: prompting prosocial behavior in preadolescents boosts peer acceptance and well-being. PLoS ONE, 7: e51380.
Leahy, RL (2005) A social–cognitive model of validation. In Compassion: Conceptualizations, Research and Use in Psychotherapy (ed Gilbert, P): 195217. Brunner-Routledge.
Leahy, RL (2008) The therapeutic relationship in cognitive-behavioral therapy. Behavioral and Cognitive Psychotherapy, 36: 769–77.
Leaviss, J, Uttley, L (2015) Psychotherapeutic benefits of compassion-focused therapy: an early systematic review. Psychological Medicine, 45: 927–45.
LeDoux, J (2003) The emotional brain, fear and the amygdala. Cellular and Molecular Neurobiology, 23: 727–38.
Lourenço, O (1992) Erro educacional fundamental: teoria, dados e implicações [Fundamental educational error: theory, data and implications]. Psicologia, 8: 385–92.
Lutz, A, Brefczynski-Lewis, J, Johnstone, T, et al (2008) Regulation of the neural circuitry of emotion by compassion meditation: effects of meditative expertise. PLoS ONE, 3: e1897.
MacBeth, A, Gumley, A (2012) Compassion and mental health: a meta-analysis of the association between self-compassion and psychopathology. Clinical Psychology Review. 32: 545–52.
Matos, M, Pinto-Gouveia, J, Gilbert, P (2013) The effect of shame and shame memories on paranoid ideation and social anxiety. Clinical Psychology and Psychotherapy, 20: 334–49.
Mikulincer, M, Shaver, PR (2007) Attachment in Adulthood: Structure, Dynamics, and Change. Guilford Press.
Neff, KD, Faso, DJ (2014) Self-compassion and well-being in parents of children with autism. Mindfulness, 6: 938–47.
Neff, KD, Dahm, KA (2015) Self-compassion: what it is, what it does, and how it relates to mindfulness. In Handbook of Mindfulness and Self-Regulation (eds Ostafin, BD, Robinson, MD, Meier, BP): 121–37. Springer.
Ozawa de Silva, B, Dodson-Lavelle, B (2011) An education of heart and mind: practical and theoretical issues in teaching cognitive-based compassion training to children. Practical Matters, 1: 128.
Pace, TWW, Negi, LT, Dodson-Lavelle, B, et al (2013) Engagement with cognitively-based compassion training is associated with reduced salivary C-reactive protein from before to after training in foster care program adolescents. Psychoneuroendocrinology. 38: 294–9.
Padesky, C (1993) Socratic Questioning: Changing Minds or Guided Discovery? Keynote address to the European Congress of Behavioural and Cognitive Therapies, London, 24 September 1993.
Perry, BD, Pollard, RA, Blakley, TL, et al (1995) Childhood trauma, the neurobiology of adaptation, and “use-dependent” development of the brain: how “states” become “traits”. Infant Mental Health Journal, 16: 271–91.
Post, SG (2014) It's Good To Be Good: 2014 biennial scientific report on health, happiness, longevity, and helping others (
Puglia, MH, Lillard, TS, Morris, JP, et al (2015) Epigenetic modification of the oxytocin receptor gene influences the perception of anger and fear in the human brain. Proceedings of the National Academy of Sciences, 112: 3308–13.
Ribeiro da Silva, D, Rijo, D, Salekin, RT (2015) The evolutionary roots of psychopathy. Aggression and Violent Behavior, 21: 8596.
Salsman, NL, Arthur, R (2012) Adapting dialectical behavior therapy to help suicidal adolescents. Current Psychiatry, 10: 1823.
Saltzman, A, Goldin, P (2008) Mindfulness-based stress reduction for school-age children. In Acceptance and Mindfulness Treatments for Children and Adolescents: A Practitioner's Guide (eds Hayes, SC, Greco, LA): 139–61. New Harbinger Publications.
Saltzman, A (2014) A Still Quiet Place: A Mindfulness Program for Teaching Children and Adolescents to Ease Stress and Difficult Emotions. New Harbinger Publications.
Schore, AN (1994) Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development. Erlbaum.
Shapiro, SL, White, C (2014) Mindful Discipline. New Harbinger.
Siegel, DJ (2001) Toward an interpersonal neurobiology of the developing mind: Attachment relationships, “mindsight,” and neural integration. Journal of Infant Mental Health, 22: 6794.
Silverton, S (2012) The Mindfulness Breakthrough. Watkins Publishing.
Tangney, JT, Tracy, JL (2012) Self-conscious emotions. In Handbook of Self and Identity (eds Leary, MR, Tangney, JP): 446–80. Guilford Press.
Turns, BA, Kimmes, J (2014) I'm NOT the problem! Externalizing children's “problems” using play therapy and developmental considerations. Contemporary Family Therapy, 36: 135–47.

Related content

Powered by UNSILO

Compassion-focused therapy with children and adolescents

  • Carlos Carona, Daniel Rijo, Céu Salvador, Paula Castilho and Paul Gilbert...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.