There is a growing body of evidence supporting the effectiveness of compassion-focused therapy (CFT) in activating self-soothing and affiliative processes (Millard et al., 2023). This therapeutic approach has shown promising outcomes in individuals with eating disorders (Gale et al., 2014), personality disorders (Lucre & Corten, 2013), and other complex difficulties (Gilbert & Procter, 2006). The present study seeks to expand the evidence for CFT in the treatment of psychosis, as previous theoretical work suggests that the targeted processes in CFT may be particularly relevant for individuals with psychosis, who often experience threat-focused cognitions (Heriot-Maitland, 2023).
To date, there have been promising outcomes for CFT in psychosis, including a case series for individuals experiencing hostile voices (Mayhew and Gilbert, 2008) and a feasibility trial for a group CFT intervention (Braehler et al., 2013). Additionally, there have been empirical investigations of CFT techniques for paranoia in clinical (Forkert et al., 2022) and non-clinical populations (Lincoln et al., 2012; Brown et al., 2020). The authors of this study developed a manualized individual Compassion-Focused Therapy for psychosis (CFTp) intervention and investigated its acceptability, effectiveness, and processes of change in a small sample of seven participants. The results showed that it is feasible to deliver CFTp in a manualized form for people experiencing distressing psychosis symptoms, with improvements in distress, stress, depression, voices, and delusions observed during the study.
The study utilized a single-case, experimental, multiple-baseline design, with participants receiving 26 sessions of the CFTp intervention, which included standard CFT content with some psychosis-specific adaptations. The outcomes were measured in participants with psychotic symptoms, depression and anxiety symptoms, psychological distress, and dissociation, among others. The study also found that changes in outcome measures were preceded by changes in process measures, supporting the effectiveness of CFTp in addressing distressing psychotic experiences. Additionally, the feasibility and acceptability of the intervention were validated, as participants showed improvements in various outcome measures, with process improvements remaining post-intervention.
The authors concluded that CFTp is a feasible and acceptable intervention for individuals with distressing psychotic experiences and indicated the potential for a pilot randomized controlled trial (RCT) of the intervention. While the study had strengths in its theoretical-driven design and treatment manual development, it also had limitations due to its small sample size and the absence of qualitative feedback from participants. In conclusion, the study provides valuable insights into the effectiveness of CFTp for individuals with distressing psychotic experiences and lays the groundwork for future research in this area.
