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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 Reference lists of key journals were hand searched and contact with experts in the field was made to identify unpublished data.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 (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
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“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
The cited source says what the claim attributes to it.
In the citing paper
“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)
The cited source says what the claim attributes to it.
In the citing paper
“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
The cited source says what the claim attributes to it.
In the citing paper
“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
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In the citing paper
“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
The cited source says what the claim attributes to it.
In the citing paper
“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”
In the citing paper
“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]
In the citing paper
“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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“A parallel stream of compassion-focused mental interventions, such as the self-compassion program [13] and compassion-J focused therapy [14], has also shown efficacy in improving mental health [15–17].”
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Martins, F. J., Palmeira, L., & Matos, M. (2025) · Mindfulness · doi:10.1007/s12671-025-02590-z · Cited by 8
Fraser, M. I., Efthymiou, A., Adamski, D., Ciarrochi, J., Gloster, A. T., & Sahdra, B. K. (2025) · Mindfulness · doi:10.1007/s12671-025-02647-z · Cited by 5
Applying a process-based therapy approach to compassion focused therapy: A synergetic alliance
Fraser, M. I., & Gregory, K. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100754 · Cited by 11
Sáez, Á. L. M. (2006) · Dialnet (Universidad de la Rioja) · Cited by 5
Keirns, N. G., Keirns, B. H., Tsotsoros, C. E., Sciarrillo, C. M., Emerson, S. R., & Hawkins, M. A. W. (2022) · Stigma and Health · doi:10.1037/sah0000381 · Cited by 7
Ghari Saadati, L., Ghorban Shiroudi, S., & Khalatbari, J. (2022) · Avicenna Journal of Nursing and Midwifery Care · doi:10.32592/ajnmc.30.1.30 · Cited by 7
Compassion apps for better mental health: qualitative review
de Krijger, E., Bohlmeijer, E. T., Geuze, E., & Kelders, S. M. (2023) · BJPsych Open · doi:10.1192/bjo.2023.537 · Cited by 9
Román-Niaves, M. S., Vasquez, C., Coo, C., Nielsen, K. M., Llorens, S., & Salanova, M. (2024) · Current Psychology · doi:10.1007/s12144-024-05959-w · Cited by 8
Coping with Tourette’s syndrome: a meta-ethnography of individual and family perspectives
Maxwell-Scott, M., O’Keeffe, F. M., & Eccles, F. J. R. (2024) · Psychology and Health · doi:10.1080/08870446.2024.2360126 · Cited by 7
Asano, K. (2019) · Case Reports in Psychiatry · doi:10.1155/2019/7214752 · Cited by 7
Of Compassion and Men: Using Compassion Focused Therapy in Working with Men
Smith, J., Lad, S., & Hiskey, S. (2019) · Springer eBooks · doi:10.1007/978-3-030-04384-1_24 · Cited by 6
Overcoming Shame: A Positive Psychology Perspective
Alex, A., & Farisha, A. T. P. (2021) · Springer eBooks · doi:10.1007/978-3-030-59527-2_10 · Cited by 5
Drobinska, K., Oakley, D., Way, C., & Jackson, M. C. (2022) · Issues in Mental Health Nursing · doi:10.1080/01612840.2022.2074177 · Cited by 5
Fears of Compassion Scales: Cross-Cultural Adaptation and Validity Evidence for Use in Brazil
Pfeiffer, S., Pereira, N. P., & Lisbôa, C. S. D. M. (2022) · Trends in Psychology · doi:10.1007/s43076-022-00220-4 · Cited by 9
Treating comorbid depression and avoidant personality disorder: The case of Andy
Maillard, P., Pellaton, J., & Kramer, U. (2019) · Journal of Clinical Psychology · doi:10.1002/jclp.22764 · Cited by 5
Kleiman, K., Marks, D. R., Block-Lerner, J., Tirch, D., Brady, V., Foote, B., & Silberstein-Tirch, L. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1509396 · Cited by 4
Buhrman, M., Tillfors, M., Holländare, F., Lekström, E., Håkansson, A., & Boersma, K. (2023) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000001157 · Cited by 5
Compassion, secure flourishing, and organizational commitment of managers
Ford, M., Rothmann, S., & van Zyl, L. E. (2024) · Frontiers in Organizational Psychology · doi:10.3389/forgp.2024.1383378 · Cited by 5
Xu, L., Goldberg, S. B., Zhang, L., & Hu, C. (2026) · Clinical Psychology Review · doi:10.1016/j.cpr.2026.102693 · Cited by 8
Metadata
- 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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