Skip to main content Accessibility help

Psychotherapeutic benefits of compassion-focused therapy: an early systematic review

  • J. Leaviss (a1) and L. Uttley (a1)



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.


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 Reference lists of key journals were hand searched and contact with experts in the field was made to identify unpublished data.


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.


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.

  • 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.

      Psychotherapeutic benefits of compassion-focused therapy: an early systematic review
      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.

      Psychotherapeutic benefits of compassion-focused therapy: an early systematic review
      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.

      Psychotherapeutic benefits of compassion-focused therapy: an early systematic review
      Available formats


This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

* Address for correspondence: Dr J. Leaviss, School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK. (Email:


Hide All
Ashworth, F, Gracey, F, Gilbert, P (2011). Compassion focused therapy after traumatic brain injury: theoretical foundations and a case illustration. Brain Impairment 12, 128139.
Atkins, D, Best, D, Briss, PA, Eccles, M, Falck-Ytter, Y, Flottorp, S, Guyatt, GH, Harbour, RT, Haugh, MC, Henry, D, Hill, S, Jaeschke, R, Leng, G, Liberati, A, Magrini, N, Mason, J, Middleton, P, Mrukowicz, J, O'Connell, D, Oxman, AD, Phillips, B, Schünemann, HJ, Edejer, T, Varonen, H, Vist, GE, Williams, JW Jr., Zaza, S; GRADE Working Group (2004). Grading quality of evidence and strength of recommendations. British Medical Journal 328, 1490.
Barnard, LK, Curry, JF (2011). Self-compassion: conceptualizations, correlates, and interventions. Review of General Psychology 15, 289303.
Beaumont, EA, Galpin, AJ, Jenkins, PE (2012). ‘Being kinder to myself’: a prospective comparative study, exploring post-trauma therapy outcome measures, for two groups of clients, receiving either cognitive behaviour therapy or cognitive behaviour therapy and compassionate mind training. Counselling Psychology Review 27, 3143.
Belsky, J, Beaver, KM (2011). Cumulative-genetic plasticity, parenting and adolescent self-regulation. Journal of Child Psychology and Psychiatry 52, 619626.
Braehler, C, Gumley, A, Harper, J, Wallace, S, Norrie, J, Gilbert, P (2013). Exploring change processes in compassion focused therapy in psychosis: results of a feasibility randomized controlled trial. British Journal of Clinical Psychology 52, 199214.
Bulmarsh, E, Harkness, KL, Stewart, JG, Bagby, RM (2009). Personality, stressful life events, and treatment response in major depression. Journal of Consulting and Clinical Psychology 77, 10671077.
Buss, DA (2009). The great struggles of life: Darwin and the emergence of evolutionary psychology. American Psychologist 64, 140148.
Carroll, C, Patterson, M, Wood, S, Booth, A, Rick, J, Balain, S (2007). A conceptual framework for implementation fidelity. Implementation Science 2, 19.
Coan, JA, Schaefer, HS, Davidson, RJ (2006). Lending a hand: social regulation of the neural response to threat. Psychological Science 17, 10321039.
Cozolino, LJ (2002). The Neuroscience of Psychotherapy: Building and Rebuilding the Human Brain. WW Norton & Company: New York, NY.
Depue, RA, Morrone-Strupinsky, JV (2005). A neurobehavioral model of affiliative bonding: implications for conceptualizing a human trait of affiliation. Behavioral and Brain Sciences 28, 313349.
Fredrickson, B, Cohn, M, Coffey, K, Finkel, S (2008). Open hearts build lives: positive emotions, induced through loving-kindness meditation, build consequential personal resources. Journal of Personality and Social Psychology 95, 10451062.
Gale, C, Gilbert, P, Read, N, Goss, K (2014). An evaluation of the impact of introducing compassion focused therapy to a standard treatment programme for people with eating disorders. Clinical Psychology and Psychotherapy 21, 112.
Gilbert, P (2000). Social mentalities: internal ‘social’ conflict and the role of inner warmth and compassion in cognitive therapy. In Genes on the Couch: Explorations in Evolutionary Psychotherapy (ed. Gilbert, P. and Bailey, K. G.), pp. 118150, Brunner-Routledge: East Sussex, UK.
Gilbert, P (2009 a). Developing a compassion-focused approach in cognitive behavioural therapy. In Cognitive Behaviour Therapy: A Guide for the Practising Clinician, vol. 2 (ed. Simos, G), pp. 205220. Routledge: East Sussex, UK.
Gilbert, P (2009 b). Introducing compassion-focused therapy. Advances in Psychiatric Treatment 15, 199208.
Gilbert, P (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology 53, 641.
Gilbert, P, Irons, C (2004). A pilot exploration of the use of compassionate images in a group of self-critical people. Memory 12, 507516.
Gilbert, P, Procter, S (2006). Compassionate mind training for people with high shame and self-criticism: overview and pilot study of a group therapy approach. Clinical Psychology and Psychotherapy 13, 353379.
Gilroy, A (2006). Art Therapy, Research and Evidence-Based Practice. Sage Publications Ltd: London.
Hawe, P, Shiell, A, Riley, T (2004). Complex interventions: how ‘out-of-control’ can a randomised controlled trial be? British Medical Journal 328, 15611563.
Higgins, JP, Altman, DG, Gøtzsche, PC, Jüni, P, Moher, D, Oxman, AD, Savovic, J, Schulz, KF, Weeks, L, Sterne, JA; Cochrane Bias Methods Group; Cochrane Statistical Methods Group (2011). The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. British Medical Journal 343, d5928.
Hofmann, SG, Grossman, P, Hinton, DE (2011). Loving-kindness and compassion meditation: potential for psychological interventions. Clinical Psychology Review 31, 11261132.
Jazaieri, H, Jinpa, GT, McGonigal, K, Rosenberg, EL, Finkelstein, J, Simon-Thomas, E, Cullen, M, Doty, JR, Gross, JJ, Goldin, PR (2013). Enhancing compassion: a randomized controlled trial of a compassion cultivation training program. Journal of Happiness Studies 14, 11131126.
Judge, L, Cleghorn, A, McEwan, K, Gilbert, P (2012). An exploration of group-based compassion focused therapy for a heterogeneous range of clients presenting to a community mental health team. International Journal of Cognitive Therapy 5, 420429.
Kelly, AC, Zuroff, DC, Foa, CL, Gilbert, P (2010). Who benefits from training in self-compassionate self-regulation? A study of smoking reduction. Journal of Social and Clinical Psychology 29, 727755.
Kelly, AC, Zuroff, DC, Shapira, LB (2009). Soothing oneself and resisting self-attacks: the treatment of two intrapersonal deficits in depression vulnerability. Cognitive Therapy and Research 33, 301313.
Kirsch, P, Esslinger, C, Chen, Q, Mier, D, Lis, S, Siddhanti, S, Gruppe, H, Mattay, VS, Gallhofer, B, Meyer-Lindenberg, A (2005). Oxytocin modulates neural circuitry for social cognition and fear in humans. Journal of Neuroscience 25, 1148911493.
Kuyken, W, Watkins, E, Holden, E, White, K, Taylor, RS, Byford, S, Evans, A, Radford, S, Teasdale, JD, Dalgleish, T (2010). How does mindfulness-based cognitive therapy work? Behaviour Research and Therapy 48, 11051112.
Laithwaite, H, O'Hanlon, M, Collins, P, Doyle, P, Abraham, L, Porter, S, Gumley, A (2009). Recovery after psychosis (RAP): a compassion focused programme for individuals residing in high security settings. Behavioural and Cognitive Psychotherapy 37, 511526.
Leary, MR, Tate, EB, Adams, CE, Batts Allen, A, Hancock, J (2007). Self-compassion and reactions to unpleasant self-relevant events: the implications of treating oneself kindly. Journal of Personality and Social Psychology 92, 887904.
LeDoux, J (1998). The Emotional Brain. Simon & Schuster: London.
Lucre, KM, Corten, N (2013). An exploration of group compassion-focused therapy for personality disorder. Psychology and Psychotherapy 86, 387400.
Lutz, A, Brefczynski-Lewis, J, Johnstone, T, Davidson, RJ (2008). Regulation of the neural circuitry of emotion by compassion meditation: effects of meditative expertise. PLoS ONE 3, e1897.
MacBeth, A, Gumley, A (2012). Exploring compassion: a meta-analysis of the association between self-compassion and psychopathology. Clinical Psychology Review 32, 545552.
Mayhew, SL, Gilbert, P (2008). Compassionate mind training with people who hear malevolent voices: a case series report. Clinical Psychology and Psychotherapy 15, 113138.
Moher, D, Liberati, A, Tetzlaff, J, Altman, DG, PRISMA, Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of Internal Medicine 151, 264269.
Neely, ME, Schallert, DL, Mohammed, SS, Roberts, RM, Chen, YJ (2009). Self-kindness when facing stress: the role of self-compassion, goal regulation, and support in college students’ well-being. Motivation and Emotion 33, 8897.
Neff, KD, Kirkpatrick, KL, Rude, SS (2007). Self-compassion and adaptive psychological functioning. Journal of Research in Personality 41, 139154.
Neff, KD, McGehee, P (2010). Self-compassion and psychological resilience among adolescents and young adults. Self and Identity 9, 225240.
Neff, KD, Vonk, R (2009). Self-compassion versus global self-esteem: two different ways of relating to oneself. Journal of Personality 77, 2350.
Nesse, R (2005). Evolutionary psychology and mental health. In The Handbook of Evolutionary Psychology (ed. Buss, D.), pp. 903929. John Wiley and Sons: Hoboken, NJ.
NICE (2004). Guideline Development Methods. Information for National Collaborating Centres and Guideline Developers. National Institute for Clinical Excellence: London.
Nutbeam, D (1998). Evaluating health promotion – progress, problems and solutions. Health Promotion International 13, 2744.
Pace, TWW, Negi, LT, Adame, DD, Cole, SP, Sivilli, TI, Brown, TD, Issa, MJ, Raison, CL (2009). Effect of compassion meditation on neuroendocrine, innate immune and behavioral responses to psychosocial stress. Psychoneuroendocrinology 34, 8798.
Pauley, G, McPherson, S (2010). The experience and meaning of compassion and self-compassion for individuals with depression or anxiety. Psychology and Psychotherapy 83, 129143.
Rector, NA, Bagby, RM, Segal, ZV, Joffe, RT, Levitt, A (2000). Self-criticism and dependency in depressed patients treated with cognitive therapy or pharmacotherapy. Cognitive Therapy and Research 24, 571584.
Rockliff, H, Gilbert, P, McEwan, K, Lightman, S, Glover, D (2008). A pilot exploration of heart rate variability and salivary cortisol responses to compassion-focused imagery. Journal of Clinical Neuropsychiatry 5, 132139.
Schanche, E, Stiles, TC, Mccullough, L, Svartberg, M, Nielsen, GH (2011). The relationship between activating affects, inhibitory affects, and self-compassion in patients with Cluster C personality disorders. Psychotherapy (Chicago, Ill.) 48, 293303.
Shapira, LB, Mongrain, M (2010). The benefits of self-compassion and optimism exercises for individuals vulnerable to depression. Journal of Positive Psychology 5, 377389.
Singer, T, Bolz, M (2014). Compassion. Bridging Practice and Science ( Accessed 28 May 2014.
Spring, B, Neville, K (2011). Evidence-based practice in clinical psychology. In The Oxford Handbook of Clinical Psychology (ed. Barlow, D. H. and Nathan, P. E.), pp. 128149. Oxford University Press: New York, NY.
The Dalai Lama (2001). An Open Heart: Practicing Compassion in Everyday Life. Little Brown & Company: Boston, MA.
Van Dam, NT, Sheppard, SC, Forsyth, JP, Earleywine, M (2011). Self-compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression. Journal of Anxiety Disorders 25, 123130.
Wood, MJ, Molassiotis, A, Payne, S (2011). What research evidence is there for the use of art therapy in the management of symptoms in adults with cancer? A systematic review. Psycho-Oncology 20, 135145.


Related content

Powered by UNSILO

Psychotherapeutic benefits of compassion-focused therapy: an early systematic review

  • J. Leaviss (a1) and L. Uttley (a1)


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.