Psychotherapeutic benefits of compassion-focused therapy: an early systematic review
Open accessAbstract
BACKGROUND: 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. METHOD: 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 Reference lists of key journals were hand searched and contact with experts in the field was made to identify unpublished data. RESULTS: 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. CONCLUSIONS: 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.
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A number of studies have provided empirical evidence for CFT's effectiveness in treating a range of conditions, including mood and anxiety disorders, substance use disorders, and OCD.
“A number of studies have provided empirical evidence for CFT’s effectiveness in treating a range of conditions, including mood and anxiety disorders (Leaviss and Uttley, 2015; Wilson et al., 2018), substance use disorders (Held et al., 2018), and OCD (Petrocchi et al., 2021).”
From Feasibility and preliminary outcomes of compassion-focused acceptance and commitment therapy delivered via telehealth in a community behavioral health clinic (2025) · cites this paper as Leaviss and Uttley, 2015
The Results report improved depression in some studies, and the Method table describes significant improvements in a mixed-diagnosis CFT group that included people with depression and anxiety. But the Results also report no between-group difference in anxiety in one study, and the Conclusions say larger, higher-quality trials are needed. The review therefore supports preliminary evidence for mood symptoms, but not a firm claim of effectiveness for anxiety disorders. Substance use disorders and OCD have separate citations in the citing sentence and are not assessed here. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPre-treatment shame proneness was not as consistently connected to treatment effect in this study.
“Pre-treatment shame proneness, which has been demonstrated to be correlated with self-compassion/self-criticism and has also been shown to be a predictor of response to compassion-focused interventions (Leaviss and Uttley, 2015), was not as consistently connected to treatment effect in this study.”
From Feasibility and preliminary outcomes of compassion-focused acceptance and commitment therapy delivered via telehealth in a community behavioral health clinic (2025) · cites this paper as Leaviss and Uttley, 2015
The Results > Moderators section reports that baseline self-criticism and related traits moderated responses to compassion-focused interventions. The paper discusses shame alongside self-criticism, but the passages do not establish that pre-treatment shame proneness itself predicts response or report its correlation with self-compassion or self-criticism. The final comparison with ‘this study’ is the citing authors’ own finding, not a claim attributed to this source. (LLM, conf=0.84)
Experimental — accuracy not yet measuredLeaviss and Uttley [72] demonstrated that CFT yields multiple therapeutic advantages, especially for individuals characterized by high self-criticism, such as maladaptive perfectionists.
“Notably, Leaviss and Uttley [72] demonstrated that CFT yields multiple therapeutic advantages, especially for individuals characterized by high self-criticism, such as maladaptive perfectionists.”
From The Influence of Positive and Negative Aspects of Perfectionism on Psychological Distress in Emerging Adulthood: Exploring the Mediating Role of Self-Compassion (2023) · cites this paper as [72]
The Discussion (‘Specificity of effects of CFT’) reports greater symptom improvement among highly self-critical individuals, and the Conclusions say CFT shows promise for them. But the review does not identify maladaptive perfectionists as a studied group, and its cautious conclusions do not establish therapeutic advantages for that group. (LLM, conf=0.86)
Experimental — accuracy not yet measuredCFT and CMT have been shown to reduce suffering and improve quality of life in a range of health problems such as anxiety/depression, eating disorders, phobias and pain management.
“CFT and CMT have been shown to reduce suffering and improve QoL in a range of health problems such as anxiety/depression, eating disorders, phobias and pain management30–33”
From SafeSpace: what is the feasibility and acceptability of a codesigned virtual reality intervention, incorporating compassionate mind training, to support people undergoing cancer treatment in a clinical setting? (2022) · cites this paper as [31]
The Results and Method table report improvements in psychological well-being, anxiety/depression measures, and eating-disorder outcomes in studies of CFT or CMT. The Discussion’s “Quality of evidence” section cautions that evidence is insufficient to establish superiority over standard treatments. The passages do not establish improved quality of life or benefits for phobias or pain management, so the full range of outcomes and conditions claimed is not supported. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThe earliest review of self-compassion-related therapies concluded that treatment effectiveness was difficult to evaluate given methodological weaknesses in the field (Leaviss and Uttley 2015).
“While the earliest review of selfcompassion-related therapies concluded that treatment effectiveness was difficult to evaluate given methodological weaknesses in the field (Leaviss and Uttley 2015)”
From Effectiveness of Self-Compassion Related Therapies: a Systematic Review and Meta-analysis (2019) · cites this paper as Leaviss and Uttley 2015
Treatment effect, as measured by quantitative outcome and process measures, may be related to pre-treatment levels of psychological inflexibility and self-criticism/self-compassion, consistent with the finding that those exhibiting higher self-criticism benefit most from compassion-focused interventions.
“Treatment effect, as measured by quantitative outcome and process measures, may be related to pre-treatment levels of psychological inflexibility, and self-criticism/self-compassion, consistent with Leaviss and Uttley’s (2015) finding that those exhibiting higher self-criticism benefit most from compassion-focused interventions”
From Feasibility and preliminary outcomes of compassion-focused acceptance and commitment therapy delivered via telehealth in a community behavioral health clinic (2025) · cites this paper as Leaviss and Uttley’s (2015)
There is empirical evidence that compassion-focused therapy and other compassion-based interventions reduce psychopathology, shame, and self-criticism, and improve well-being, particularly with adolescents.
“There is empirical evidence of CFT and other compassion-based interventions in reducing psychopathology, shame, and self-criticism, and improving well-being (Kirby, 2017; Leaviss & Uttley, 2015), particularly with adolescents (Bluth et al., 2016; Figueiredo et al., 2021)”
From THE EFFICACY OF A COMPASSION, ACCEPTANCE AND MINDFULNESS-BASED PILOT INTERVENTION FOR ADOLESCENTS’ TEST ANXIETY: A CASE STUDY USING THE ACADEMIC PROGRAM (2023) · cites this paper as Leaviss & Uttley, 2015
CFT appears efficacious in treating a range of clinical populations, although existing studies vary considerably in study quality and intervention content and format.
“This growing body of literature has been synthesized in several systematic reviews, which generally conclude that CFT appears efficacious in treating a range of clinical populations, although the existing studies vary considerably in terms of study quality and content of the therapeutic intervention and -format (Beaumont and Martin, 2015; Craig et al., 2020; Leaviss and Uttley, 2015).”
From Group-based compassion-focused therapy for prolonged grief symptoms in adults – Results from a randomized controlled trial (2022) · cites this paper as Leaviss and Uttley, 2015
CFT aims to facilitate compassion in order to increase psychological well-being.
“CFT aims to facilitate compassion in order to increase psychological well-being (Leaviss and Uttley, 2015).”
From Group-based compassion-focused therapy for prolonged grief symptoms in adults – Results from a randomized controlled trial (2022) · cites this paper as Leaviss and Uttley, 2015
Researchers have trialled a number of different durations of CFT groups and follow-up periods.
“As the evidence base of using CFT in groups emerges, researchers have trialled a number of different durations of groups and follow-up periods.16”
Cultivating compassion for self and others has become a central focus for the development of psychotherapies.
“Cultivating compassion for self and others has also become a central focus for the development of psychotherapies [35, 37, 40, 61, 67, 69, 77, 96].”
From The development of compassionate engagement and action scales for self and others (2017) · cites this paper as [77]
It is likely that most compassion focused therapies work in both direct and indirect ways on mental health problems.
“it is likely that most compassion focused therapies, for which there a few now [69] work in both direct and indirect ways on mental health problems [67, 69, 77].”
From The development of compassionate engagement and action scales for self and others (2017) · cites this paper as [77]
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“Compassion training improves general well-being and social relationships (33, 34), with increasing evidence of its effectiveness as a psychotherapy (11, 35, 36).”
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- Authors
- Leaviss, J., & Uttley, L.
- Affiliations
- University of Sheffield (GB)
- Corresponding author
- Leaviss, J.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2014-09-12
- Volume
- 45
- Issue
- 5
- Pages
- 927-945
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC4413786
- OpenAlex
- W2150285866
- Cited by
- 546
- References
- 64
- Citations by year
- 2026: 34 · 2025: 48 · 2024: 55 · 2023: 50 · 2022: 50 · 2021: 56 · 2020: 104 · 2019: 41 · 2018: 28 · 2017: 41 · 2016: 19 · 2015: 17 · 2014: 1
- FWCI
- 3.93
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Psychological Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Funders
- University of Sheffield
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- compassion-focused therapy, shame, self-criticism, mood disorders, treatment efficacy, evidence-based practice
- MeSH terms
- Mental Disorders, Empathy, Humans, Psychotherapy, Self Concept, Shame, Treatment Outcome
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